Acute disseminated candidiasis with skin lesions: a systematic review.

Science.gov (United States)

Guarana, M; Nucci, M

2018-03-01

Neutropenic patients developing acute disseminated candidiasis may present with skin lesions. To evaluate the epidemiology of acute disseminated candidiasis with skin lesions in neutropenic patients, taking into consideration changes caused by different prophylactic strategies. A systematic review of English-language articles found via PubMed (1963-2016) was performed. We asked the following questions: (a) What Candida species are more frequently involved in this syndrome? (b) Has antifungal prophylaxis changed the species causing skin lesions? (c) What are the typical patterns of skin lesions? (d) What is the frequency of skin lesions in neutropenic patients with candidaemia or acute disseminated candidiasis? (e) Has antifungal prophylaxis decreased the incidence of acute disseminated candidiasis with skin lesions? Among 183 studies, 33 were selected, reporting 100 cases of acute disseminated candidiasis with skin lesions in neutropenic patients. It occurred more frequently in the setting of induction therapy for de novo or relapsed acute leukaemia, and the most frequent Candida species were C. tropicalis (68%) and C. krusei (15%). Diffuse maculopapular lesions predominated in cases caused by C. tropicalis and nodular and papular lesions in cases caused by C. krusei. Prophylaxis with fluconazole was reported in six cases, C. krusei in five and C. ciferrii in one. The death rate was 45.4%. Two patterns were recognized: disseminated maculopapular lesions caused by C. tropicalis in patients not receiving fluconazole prophylaxis, occurring in 39% to 44% of neutropenic patients with acute disseminated candidiasis, and nodular lesions caused by C. krusei in patients receiving fluconazole prophylaxis, occurring less frequently. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Implementation and analysis of relief patterns of the surface of benign and malignant lesions of the skin by microtopography

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Lopez Pacheco, Maria del Carmen Lopez [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico); Martins-Costa, Manuel Filipe Pereira da Cunha [Departamento de Fisica, Universidad do Minho, Escola de Ciencias Campus de Gualtar-PT-4710-057 Braga (Portugal); Zapata, Aura Judith Perez [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico); Cherit, Judith DomInguez [Departamento de DermatologIa, Hospital General Dr Manuel Gea Gonzalez, Calzada de Tlalpan No 4800, 14000 (Mexico); Gallegos, Eva Ramon [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico)

2005-12-07

The objective of this study was to be able to distinguish between healthy skin tissue and malignant ones, furthermore determining a unique pattern of roughness for each skin lesion by microtopographic analysis of the skin surface of Mexican patients during the period from April to October 2002. The standard technique used in this study for the diagnosis of skin cancer and the comparison of the results was the haematoxylin-eosin histopathological technique. Latex impressions were taken from skin lesions as well as from the healthy skin of each patient to serve as control samples. These impressions were analysed by the MICROTOP.03.MFC microtopographic system inspection. It was observed that when the tumour becomes rougher, more malign will be the lesion. On average, the melanoma present an increase of roughness of 67% compared to healthy skin, obtaining a roughness relation of 1:2.54. The percentage decreases to 49% (49%, 1:60) in the case of basal cell carcinoma and to 40% in pre-malignant lesions such as melanocytic nevus (40%, 1:150). In benign lesions such as the seborrhoea keratosis only a small increase in roughness was noted (4%, 1:0.72). Microtopographic inspection of the skin surface can be considered as a complementary diagnostic technique for skin cancer.

Implementation and analysis of relief patterns of the surface of benign and malignant lesions of the skin by microtopography

International Nuclear Information System (INIS)

Lopez Pacheco, Maria del Carmen Lopez; Martins-Costa, Manuel Filipe Pereira da Cunha; Zapata, Aura Judith Perez; Cherit, Judith DomInguez; Gallegos, Eva Ramon

2005-01-01

The objective of this study was to be able to distinguish between healthy skin tissue and malignant ones, furthermore determining a unique pattern of roughness for each skin lesion by microtopographic analysis of the skin surface of Mexican patients during the period from April to October 2002. The standard technique used in this study for the diagnosis of skin cancer and the comparison of the results was the haematoxylin-eosin histopathological technique. Latex impressions were taken from skin lesions as well as from the healthy skin of each patient to serve as control samples. These impressions were analysed by the MICROTOP.03.MFC microtopographic system inspection. It was observed that when the tumour becomes rougher, more malign will be the lesion. On average, the melanoma present an increase of roughness of 67% compared to healthy skin, obtaining a roughness relation of 1:2.54. The percentage decreases to 49% (49%, 1:60) in the case of basal cell carcinoma and to 40% in pre-malignant lesions such as melanocytic nevus (40%, 1:150). In benign lesions such as the seborrhoea keratosis only a small increase in roughness was noted (4%, 1:0.72). Microtopographic inspection of the skin surface can be considered as a complementary diagnostic technique for skin cancer

Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

OpenAIRE

Dimitre Dimitrov; Radomir Reszke; Jacek Szepietowski

2016-01-01

Introduction . Patients with self-inflicted skin lesions (SISL) are most often referred to dermatologists. Since psychological and psychiatric conditions might be the underlying reasons for the behavior of these patients, the psychology-associated component should always be kept in mind when approaching such individuals. Objective. To discuss distinctive aspects of the approach towards patients with SISL and emphasize the most relevant issues concerning the management of psychodermatose...

P63 marker Expression in Usual Skin Cancers Compared With Non Tumoral Skin Lesions

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Abdolhamid Esmaili

2017-07-01

Full Text Available Background: Non-melanoma skin cancers including basal cell carcinoma and squamous cell carcinoma are the most common cancers in human. The aim of this study was to determine the expression of P63 marker in usual skin cancers compared with non-tomoral skin lesions. Materials and Methods: In this cross-sectional study, sampling was performed from archival blocks of Shahid Mohammadi hospital patients during 2010-2011. 60 samples (including 30 samples of non tumoral skin lesions and 30 samples of basal cell carcinoma and squamous cell carcinoma were studied and evaluation of p63 gene expression was done with Immunohistochemistry method. T-test and Chi-square were used for analysis of data. Results: P63 gene were expressed in 4 cases (13.33 % of non tumoral lesions and all tumoral lesions (100 %. In tumoral lesions, 5 cases (16.66 % showed 1+ severity experssion, 11 cases (36.66% 2 + severity experssion and 14 cases (46.66 % 3+severity experssion. All 4 non tumoral lesions shoed 1+ severity experssion of P63gene. Conclusion: The results of this study indicated that the incidence and severity of gene expression of P63 can be use for differentiation between basal cell carcinoma and squamous cell carcinoma as well as non-tumoral skin lesions. 

Pigmented skin lesion detection using random forest and wavelet-based texture

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Hu, Ping; Yang, Tie-jun

2016-10-01

The incidence of cutaneous malignant melanoma, a disease of worldwide distribution and is the deadliest form of skin cancer, has been rapidly increasing over the last few decades. Because advanced cutaneous melanoma is still incurable, early detection is an important step toward a reduction in mortality. Dermoscopy photographs are commonly used in melanoma diagnosis and can capture detailed features of a lesion. A great variability exists in the visual appearance of pigmented skin lesions. Therefore, in order to minimize the diagnostic errors that result from the difficulty and subjectivity of visual interpretation, an automatic detection approach is required. The objectives of this paper were to propose a hybrid method using random forest and Gabor wavelet transformation to accurately differentiate which part belong to lesion area and the other is not in a dermoscopy photographs and analyze segmentation accuracy. A random forest classifier consisting of a set of decision trees was used for classification. Gabor wavelets transformation are the mathematical model of visual cortical cells of mammalian brain and an image can be decomposed into multiple scales and multiple orientations by using it. The Gabor function has been recognized as a very useful tool in texture analysis, due to its optimal localization properties in both spatial and frequency domain. Texture features based on Gabor wavelets transformation are found by the Gabor filtered image. Experiment results indicate the following: (1) the proposed algorithm based on random forest outperformed the-state-of-the-art in pigmented skin lesions detection (2) and the inclusion of Gabor wavelet transformation based texture features improved segmentation accuracy significantly.

The measurement of skin impedance for the diagnosis of skin cancer

International Nuclear Information System (INIS)

Menzies, S.; Crook, B.; McCarthy, W.

1996-01-01

Full text: In vivo skin impedance measurements have been reported to be diagnostic in differentiating benign from malignant skin tumours (Kiss G et al. Borgyogy Vener Szle 45: 164,1969; Melczer N. In: Cancer of the Skin. Saunders Co. Philadelphia, 1976, pp293-313). However, in contrast to non-melanoma skin cancer, only, a small sample of malignant melanomas were reported in these previous studies. We performed skin impedance measurements on a larger sample of melanomas in order to assess the potential use of such instrumentation for clinical diagnosis. The diagnostic method described by Kiss and Horvath was reproduced with only minor modifications. Low voltage impedance measurements at 1600 Hz were taken over each lesion and on nearby surrounding normal skin. Filter paper (4mm diameter) soaked in 0.1 M KCl was used at the skin-probe interface. A minimum of 2 skin and 1 lesion measurements were taken. All lesions were taken from relatively hairless sites and were non abraded or ulcerated. With the exception of 6 seborrhoeic keratoses all lesions were excised for histological diagnosis. The lesions tested were 27 invasive melanomas, 3 in situ melanomas, 27 basal cell carcinomas (BCC), 70 benign melanocytic lesions, 19 seborrhoeic keratoses, 5 Bowens disease (in situ SCC), 1 squamous cell carcinoma (SCC) and 25 other benign lesions. Results were interpreted as previously (Melczer) by the quotient of skin impedance / lesion impedance > 1.5 indicating malignancy. Analysis of total melanocytic lesions gave a sensitivity of 44% and specificity of 83% for the diagnosis of invasive melanoma (p < 0.05). Fifty two percent of BCCs were positively diagnosed. Analysis of all benign versus all invasive malignancy gave a sensitivity of 47% and specificity of 77% for the diagnosis of invasive malignancy (p < 0.01). While impedance measurements at 1600 Hz provide a statistically significant differentiation of melanoma versus non-melanoma and invasive malignancy versus benign lesions

Skin lesions in hospitalized cases of dengue fever

International Nuclear Information System (INIS)

Saleem, K.; Shaikh, I.

2008-01-01

To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M (IgM) serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre (JPMC) and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count (TLC and DLC), platelet count and Liver Function Tests (LFTs) were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness (seen in 86% patients). The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds (seen in 14% patients). Sixty-eight (68%) patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 (65%) cases. Discrete petechial lesions were seen on various body areas in 24 (35%) cases. Palmer erythema was seen in 20 (30%) patients. Generalized itching was seen in 16 (23%) cases. Isolated itching of palms and soles was seen in 20 (30%) cases. Twenty-eight (28%) patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT. Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases. (author)

Skin lesions in hospitalized cases of dengue fever

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Saleem, K; Shaikh, I [Jinnah Postgraduate Medical Hospital, Karachi (Pakistan)

2008-10-15

To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M (IgM) serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre (JPMC) and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count (TLC and DLC), platelet count and Liver Function Tests (LFTs) were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness (seen in 86% patients). The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds (seen in 14% patients). Sixty-eight (68%) patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 (65%) cases. Discrete petechial lesions were seen on various body areas in 24 (35%) cases. Palmer erythema was seen in 20 (30%) patients. Generalized itching was seen in 16 (23%) cases. Isolated itching of palms and soles was seen in 20 (30%) cases. Twenty-eight (28%) patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT. Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases. (author)

The value of Tzanck smear test in diagnosis of erosive, vesicular, bullous, and pustular skin lesions.

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Durdu, Murat; Baba, Mete; Seçkin, Deniz

2008-12-01

Tzanck smear is generally used for the diagnosis of the pemphigus group of autoimmune bullous diseases and mucocutaneous herpesvirus infections. There are only a few studies in the literature investigating its diagnostic value. We aimed to investigate Tzanck smear findings and to determine the diagnostic value of this test in moist (erosive, vesicular, bullous, and pustular) skin lesions. We also aimed to develop an algorithmic approach for the diagnosis of these types of skin lesions according to the Tzanck smear findings. Samples were stained with May-Grünwald-Giemsa and evaluated by the same dermatologist. In some patients, methylene blue and Gram staining or direct immunofluorescence examinations were additionally performed. In all of the study cases, after the evaluation of clinical and laboratory findings (including, when appropriate, potassium hydroxide examination; viral serology; bacterial and fungal cultures; histopathology; direct and indirect immunofluorescence; patch testing), the definite diagnosis was established. We also determined the sensitivity and the specificity of certain Tzanck smear findings. Tzanck smear was performed in a total of 400 patients with moist skin lesions. The sensitivities of multinucleated giant cells and acantholytic cells in herpetic infections, dyskeratotic acantholytic cells and cocci in bullous impetigo, pseudohyphae in candidiasis, acantholytic cells in pemphigus and more than 10 tadpole cells (magnification x100) in spongiotic dermatitis were 84.7%, 92%, 100%, 100%, and 81.5%, respectively. Because Tzanck smears were evaluated by the same dermatologist, no comment could be made regarding the interobserver reliability of this test and how the level of experience with this technique might affect the results. Also, the sensitivity and the specificity of Tzanck smear test findings for certain diseases could not be calculated because of an insufficient number of patients. The Tzanck smear test is an inexpensive, useful

Relationship between arsenic skin lesions and the age of natural menopause.

Science.gov (United States)

Yunus, Fakir Md; Rahman, Musarrat Jabeen; Alam, Md Zahidul; Hore, Samar Kumar; Rahman, Mahfuzar

2014-05-02

Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women's reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. We compared menopausal age in two groups of women--with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies--participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups' age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions. The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers.

Science.gov (United States)

Fernandes, Ana R; Santos, Ana C; Sanchez-Lopez, Elena; Kovačević, Andjekla B; Espina, Marta; Calpena, Ana C; Veiga, Francisco J; Garcia, Maria L; Souto, Eliana B

2018-01-01

Neoplastic skin lesions are multifocal, diffuse skin infiltrations of particular relevance in the differential diagnosis of ulcerative, nodular, or crusting skin lesions. Nonmelanoma skin cancers (NMSCs), namely, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and also actinic keratosis (AK), are the most common malignant tumors in humans. BCCs do not proliferate rapidly and most of the times do not metastasize, while SCCs are more infiltrative, metastatic, and destructive. AKs are precursor lesions of cutaneous SCCs. The classical therapy of NMSCs makes use of photodynamic therapy associated with chemotherapeutics. With improved understanding of the pathological mechanisms of tumor initiation, progression, and differentiation, a case is made towards the use of targeted chemotherapy with the intent to reduce the cytotoxicity of classical treatments. The present review aims to describe the current state of the art on the knowledge of NMSC, including its risks factors, oncogenes, and skin carcinogenesis, discussing the classical therapy against new therapeutic options. © 2017 S. Karger AG, Basel.

Skin lesions in hospitalized cases of dengue Fever.

Science.gov (United States)

Saleem, Khawer; Shaikh, Irfan

2008-10-01

To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. Case series. Three tertiary care hospitals of Karachi, from November 2006 to February 2007. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M (IgM) serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre (JPMC) and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count (TLC and DLC), platelet count and Liver Function Tests (LFTs) were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness (seen in 86% patients). The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds (seen in 14% patients). Sixty-eight (68%) patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 (65%) cases. Discrete petechial lesions were seen on various body areas in 24 (35%) cases. Palmer erythema was seen in 20 (30%) patients. Generalized itching was seen in 16 (23%) cases. Isolated itching of palms and soles was seen in 20 (30%) cases. Twenty-eight (28%) patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT. Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases.

Clinical analysis of skin lesions in 796 Chinese HIV- positive patients.

Science.gov (United States)

Huang, Xiao-jie; Li, Hai-ying; Chen, De-xi; Wang, Xi-cheng; Li, Zai-chun; Wu, Ya-song; Zhang, Tong; Gao, Yan-qing; Wu, Hao

2011-09-01

Skin lesions are often associated with human immunodeficiency virus (HIV) infection, reflecting the immunocompromised status of the individual. We investigated the relationship between skin lesions and immune function in a retrospective study of 796 Chinese HIV patients with and without highly active antiretroviral therapy (HAART). Of the 651 patients who had not received HAART, we found that 531 (81.6%) had apparent skin lesions. The incidence of infectious skin diseases (fungi, viruses, bacteria, spirochetes and parasites) and non-infectious skin diseases (excluding skin cancer) was 68.8% and 34.9%, respectively. Mean CD4(+) T-cell counts and CD4(+)/CD8(+) ratios were lower in patients with skin lesions than in patients without lesions (178 ± 96/µl vs. 306 ± 189/µl (p Candidiasis (25.8%), eczema (19.2%), nodular prurigo (13.8%), dermatophyte infections (10.6%) and herpes zoster (9.4%) were most common in Chinese patients with HIV. Among the 145 patients who had started HAART, there was a significantly lower prevalence of skin diseases (29.0%), although drug eruptions (12.4%) were more commonly observed. These findings indicate that HAART often reduces the incidence of infectious and non-infectious skin lesions in patients with HIV, but can itself be the cause of drug eruptions.

The spectrum of non- neoplastic skin lesions in Ibadan, Nigeria: a ...

African Journals Online (AJOL)

The other common specific skin lesions were lichen planus/lichenoid dermatitis 27(12.9% of 209 cases), verruca vulgaris 25 (12% of 209 cases). Conclusion: The number of histologically diagnosed non-neoplastic skin lesions is relatively small. There is a very wide spectrum of non-neoplastic skin lesions diagnosed within ...

Adaptive technique for matching the spectral response in skin lesions' images

International Nuclear Information System (INIS)

Pavlova, P; Borisova, E; Avramov, L; Pavlova, E

2015-01-01

The suggested technique is a subsequent stage for data obtaining from diffuse reflectance spectra and images of diseased tissue with a final aim of skin cancer diagnostics. Our previous work allows us to extract patterns for some types of skin cancer, as a ratio between spectra, obtained from healthy and diseased tissue in the range of 380 – 780 nm region. The authenticity of the patterns depends on the tested point into the area of lesion, and the resulting diagnose could also be fixed with some probability. In this work, two adaptations are implemented to localize pixels of the image lesion, where the reflectance spectrum corresponds to pattern. First adapts the standard to the personal patient and second – translates the spectrum white point basis to the relative white point of the image. Since the reflectance spectra and the image pixels are regarding to different white points, a correction of the compared colours is needed. The latest is done using a standard method for chromatic adaptation. The technique follows the steps below: –Calculation the colorimetric XYZ parameters for the initial white point, fixed by reflectance spectrum from healthy tissue; –Calculation the XYZ parameters for the distant white point on the base of image of nondiseased tissue; –Transformation the XYZ parameters for the test-spectrum by obtained matrix; –Finding the RGB values of the XYZ parameters for the test-spectrum according sRGB; Finally, the pixels of the lesion's image, corresponding to colour from the test-spectrum and particular diagnostic pattern are marked with a specific colour

Skin and cutaneous melanocytic lesion simulation in biomedical optics with multilayered phantoms

Energy Technology Data Exchange (ETDEWEB)

Urso, P [Department of Occupational and Environmental Health, Hospital L. Sacco Unit, University of Milan, Via G B Grassi, 74-20157 Milan (Italy); Lualdi, M [Medical Physics Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1-20133 Milan (Italy); Colombo, A [Medical Physics Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1-20133 Milan (Italy); Carrara, M [Medical Physics Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1-20133 Milan (Italy); Tomatis, S [Medical Physics Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1-20133 Milan (Italy); Marchesini, R [Medical Physics Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1-20133 Milan (Italy)

2007-05-21

The complex inner layered structure of skin influences the photon diffusion inside the cutaneous tissues and determines the reflectance spectra formation. Phantoms are very useful tools to understand the biophysical meaning of parameters involved in light propagation through the skin. To simulate the skin reflectance spectrum, we realized a multilayered skin-like phantom and a multilayered skin phantom with a melanoma-like phantom embedded inside. Materials used were Al{sub 2}O{sub 3} particles, melanin of sepia officinalis and a calibrator for haematology systems dispersed in transparent silicon. Components were optically characterized with indirect techniques. Reflectance phantom spectra were compared with average values of in vivo spectra acquired on a sample of 573 voluntary subjects and 132 pigmented lesions. The phantoms' reflectance spectra agreed with those measured in vivo, mimicking the optical behaviour of the human skin. Further, the phantoms were optically stable and easily manageable, and represented a valid resource in spectra formation comprehension, in diagnostic laser applications and simulation model implementation, such as the Monte Carlo code for non-homogeneous media. (note)

Skin and cutaneous melanocytic lesion simulation in biomedical optics with multilayered phantoms

International Nuclear Information System (INIS)

Urso, P; Lualdi, M; Colombo, A; Carrara, M; Tomatis, S; Marchesini, R

2007-01-01

The complex inner layered structure of skin influences the photon diffusion inside the cutaneous tissues and determines the reflectance spectra formation. Phantoms are very useful tools to understand the biophysical meaning of parameters involved in light propagation through the skin. To simulate the skin reflectance spectrum, we realized a multilayered skin-like phantom and a multilayered skin phantom with a melanoma-like phantom embedded inside. Materials used were Al 2 O 3 particles, melanin of sepia officinalis and a calibrator for haematology systems dispersed in transparent silicon. Components were optically characterized with indirect techniques. Reflectance phantom spectra were compared with average values of in vivo spectra acquired on a sample of 573 voluntary subjects and 132 pigmented lesions. The phantoms' reflectance spectra agreed with those measured in vivo, mimicking the optical behaviour of the human skin. Further, the phantoms were optically stable and easily manageable, and represented a valid resource in spectra formation comprehension, in diagnostic laser applications and simulation model implementation, such as the Monte Carlo code for non-homogeneous media. (note)

Measurement of some biophysical parameters in skin lesions of leprosy

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A B Gupta

1990-01-01

Full Text Available Transepidermal water loss (TEWL, high frequency electrical conductance (HFC and the hydration state index (HSI were measured in sldn lesions of 30 paucibacillary leprosy patients and compared with the contralateral uninvolved skin. While the TEWL, HFC and HSI all showed lower values in the lesion site, as compared to the contralateral skin sites, the differences between the two sets of values significant in HFC and. HSI only at 2% and 1% level respectively. A significant positive correlation (r = 0.69 was found to eidst between these two parameters. The parameters correlate well with the known reduced sweating in skin lesions of TT and BT leprosy and may therefore be considered as good objective parameters to confirm hypohydrosis in suspected skin lesions ofleprosy.

CLINICOPATHOLOGICAL STUDY OF PAPULOSQUAMOUS SKIN LESIONS

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Chowdari Balaji

2018-02-01

Full Text Available BACKGROUND Papulosquamous lesions form the largest group of skin diseases. Since, they are all characterized by scaling papules or plaques, clinical confusion may result in their diagnosis, hence definitive histopathological analysis is important for their differentiation. MATERIALS AND METHODS The study includes skin biopsies from 108 clinically diagnosed /suspected non-infectious, erythematous, papulosquamous skin diseases which were received in the Department of Pathology, Andhra Medical College, Visakhapatnam for a period of two years from January 2016 to December 2017. The specimens obtained were subjected to formalin fixation and was subjected to routine processing and sections were stained with haematoxylin and eosin (H&E. The lesions were classified as Lichen Planus, Psoriasis, along with rare conditions like Pityriasis Rosea, Parapsoriasis, Pityriasis Rubra Pilaris, Prurigo Nodularis and Lichen Simplex chronicus and clinicopathological correlation was done. RESULTS A total of 108 cases were studied. Lichen planus (51 cases- 47.22% was the most common lesions followed by Psoriasis (34 cases - 31.48% and with majority of cases in the age group of 21 to 30 years (25 cases– 23.15%. Females were more commonly affected with a male to female ratio of 0.89:1. Out of 108 cases, clinicopathological correlation was seen in 68 cases (62.96%. CONCLUSION The importance of specific histopathological diagnosis lies in distinguishing these lesions into different entities as the treatment and prognosis varies widely and is disease-specific.

Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network

Science.gov (United States)

2018-01-01

Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved. PMID:29439500

Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network

Directory of Open Access Journals (Sweden)

Yuexiang Li

2018-02-01

Full Text Available Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1, lesion dermoscopic feature extraction (task 2 and lesion classification (task 3. A deep learning framework consisting of two fully convolutional residual networks (FCRN is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved.

Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network.

Science.gov (United States)

Li, Yuexiang; Shen, Linlin

2018-02-11

Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved.

Etiology of chronic skin lesions in subjects with peripheral arterial disease.

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Chisari, G; Chisari, E M; Borzì, A M; Grasso, A; Chisari, C G

2018-01-01

Skin lesions can be defined as lesions that result in loss of tissues and their joints, and often this cutaneous skin process is a primary or secondary consequence of the structural changes in the skin itself. Subjects with peripheral arteripathies that develop chronic skin lesions in the lower extremities of the Western world are constantly increasing. We conducted a study on the etiologic incidence of chronic skin lesions in peripheral arterial disease CSLpa subjects in the lower limbs compared to subjects with chronic skin lesions CSL (controls). 30 subjects with peripheral atheropathies PA (22 F - 8 M mean age 74,5 ± 4,9) and with chronic skin lesions (CSLpa) in the lower limbs "A" group were admitted to our study according to a randomized and compared to 30 no peripheral atheropathies subjects (19 F-11 M, mean age 81,5 ± 7,3 - controls) group B with chronic skin lesions (CSL). These two groups "A" and "B" have been studied and compared on the basis of infectious etiology responsible for the infectious skin process. In the subjects of the "A" group we found a 12 positive assay of 40.0% of the examinations, while in the group "B" we achieved a total cultured positivity of 9 cases corresponding to 30.0% of the examinations . For the number of bacterial species identified for "A" group we obtained 3 mono microbial and 6 poly microbial bacteriological tests and for group "B" we observed 7 mono microbial and 2 poly microbial tests. All bacteriological isolates showed "in vitro" sensitivity to satisfactory ciprofloxacin with MICs range of 0.78-1.56mg/L. The data observed after 4 weeks after the amniotic membrane (MA) in the two study groups A and B were respectively the following: and for group A 50% scarring, 46.6% partial resolution and in one case worsening for the B-healing group in 63.3%, the partial resolution in the remaining 36.6. The data from this study show a different etiology between subjects with CSLpa than subjects with CSL. This phenomenon confirms

Location of skin lesions in Henoch-Schönlein purpura and its association with significant renal involvement.

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St John, Jessica; Vedak, Priyanka; Garza-Mayers, Anna Cristina; Hoang, Mai P; Nigwekar, Sagar U; Kroshinsky, Daniela

2018-01-01

Henoch-Schönlein purpura (HSP) is a small vessel IgA-predominant vasculitis. To describe adult patients with HSP and determine if the distribution of skin lesions (ie, purpura above the waist or purpura below the waist only), is a predictor of significant renal involvement at the time of the skin biopsy and the months following. A retrospective study on renal function from 72 adult patients with skin-biopsy proven HSP. Longitudinal renal data were analyzed after HSP diagnosis by using baseline renal function for comparison. Statistical analysis adjusted for sex, age, and baseline creatinine revealed a trend between HSP lesions only on the upper and lower extremities and long-term renal involvement (4.767, P = .067). Moreover, in another analysis adjusted for age and baseline creatinine, lesions located only on the upper and lower extremities significantly increased the odds of having long-term significant renal involvement (6.55, P = .049) in men. This retrospective study used patient information that was subject to selection bias. In patients with HSP, skin lesion distribution on the extremities might be predictive of significant long-term renal involvement and might be critical for risk stratification and development of personalized diagnostics and therapeutics. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Automated segmentation of pigmented skin lesions in multispectral imaging

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Carrara, Mauro; Tomatis, Stefano; Bono, Aldo; Bartoli, Cesare; Moglia, Daniele; Lualdi, Manuela; Colombo, Ambrogio; Santinami, Mario; Marchesini, Renato

2005-01-01

The aim of this study was to develop an algorithm for the automatic segmentation of multispectral images of pigmented skin lesions. The study involved 1700 patients with 1856 cutaneous pigmented lesions, which were analysed in vivo by a novel spectrophotometric system, before excision. The system is able to acquire a set of 15 different multispectral images at equally spaced wavelengths between 483 and 951 nm. An original segmentation algorithm was developed and applied to the whole set of lesions and was able to automatically contour them all. The obtained lesion boundaries were shown to two expert clinicians, who, independently, rejected 54 of them. The 97.1% contour accuracy indicates that the developed algorithm could be a helpful and effective instrument for the automatic segmentation of skin pigmented lesions. (note)

Enhanced diagnostic of skin conditions by polarized laser speckles: phantom studies and computer modeling

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Tchvialeva, Lioudmila; Lee, Tim K.; Markhvida, Igor; Zeng, Haishan; Doronin, Alexander; Meglinski, Igor

2014-03-01

The incidence of the skin melanoma, the most commonly fatal form of skin cancer, is increasing faster than any other potentially preventable cancer. Clinical practice is currently hampered by the lack of the ability to rapidly screen the functional and morphological properties of tissues. In our previous study we show that the quantification of scattered laser light polarization provides a useful metrics for diagnostics of the malignant melanoma. In this study we exploit whether the image speckle could improve skin cancer diagnostic in comparison with the previously used free-space speckle. The study includes skin phantom measurements and computer modeling. To characterize the depolarization of light we measure the spatial distribution of speckle patterns and analyse their depolarization ratio taken into account radial symmetry. We examine the dependences of depolarization ratio vs. roughness for phantoms which optical properties are of the order of skin lesions. We demonstrate that the variation in bulk optical properties initiates the assessable changes in the depolarization ratio. We show that image speckle differentiates phantoms significantly better than free-space speckle. The results of experimental measurements are compared with the results of Monte Carlo simulation.

Skin lesions in Lorestan province chemically wounded combatants

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roghaye Jebraili

2004-01-01

Findings: All of the studied cases with mean age of 39.26 years old had skin manifestations among which the most common symptoms were itching , burning ,dry skin , scaling. From view point of lesions, the most common signs were erythema (81% , excoriation (87.9% and pruritic papules (49.5%. Final diagnosis in 78% of the patients was chronic dermatitis and in 7.7% of them was seborrhoeic dermatitis and in 8.8% both chronic and seborrhoeic dermatitis were observed .During exposure to chemical gases only 37.9% of these combatants had used special masks and 40% had properly worn special clothes to protect themselves which covered their body completely , but rest of them had either used protection instruments improperly or had not used them at all. Most of the lesions were in trunk , lower extremities , abdomen , head and neck .78% of the cases had multiple lesions Conclusion: Regarding the results of this study all of the chemical wounded combatants of Lorestan province suffer from different degrees of skin lesions , although more than half of them were not aware of kind and nature of the chemical gases , but it is suggested to do further studies on long-term effects of these chemical gases.

Diospyros lotus leaf and grapefruit stem extract synergistically ameliorate atopic dermatitis-like skin lesion in mice by suppressing infiltration of mast cells in skin lesions.

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Cho, Byoung Ok; Che, Denis Nchang; Yin, Hong Hua; Shin, Jae Young; Jang, Seon Il

2017-05-01

Atopic dermatitis, a chronic relapsing and pruritic inflammation of the skin also thought to be involved in, or caused by immune system destruction is an upsetting health problem due to its continuously increasing incidence especially in developed countries. Mast cell infiltration in atopic dermatitis skin lesions and its IgE-mediated activation releases various cytokines and chemokines that have been implicated in the pathogenesis of atopic dermatitis. This study was aimed at investigating synergistic anti-inflammatory, anti-pruritic and anti-atopic dermatitis effects of Diospyros lotus leaf extract (DLE) and Muscat bailey A grapefruit stem extract (GFSE) in atopic dermatitis-like induced skin lesions in mice. Combinations of DLE and GFSE inhibited TNF-α and IL-6 production more than DLE or GFSE in PMA plus calcium ionophore A23187-activated HMC-1 cells. DLE and GFSE synergistically inhibited compound 48/80-induced dermal infiltration of mast cells and reduced scratching behavior than DLE or GFSE. Furthermore, DLE and GFSE synergistically showed a stronger ameliorative effect in skin lesions by reducing clinical scores; dermal infiltration of mast cells; ear and dorsal skin thickness; serum IgE and IL-4 production in atopic dermatitis-like mice. Collectively, these results suggest that DLE and GFSE synergistically exhibit anti-atopic dermatitis effects in atopic dermatitis-like skin lesions in mice. Copyright © 2017. Published by Elsevier Masson SAS.

Polymorphous light eruption. Experimental reproduction of skin lesions

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Hoelzle, E.; Plewig, G.; Hofmann, C.; Roser-Maass, E.

1982-01-01

The clinical features of polymorphous light eruption (PLE) are reviewed from the literature with special emphasis on the experimental reproduction of skin lesions. Our clinical experience with 180 patients is reported. In forty-three patients a newly developed UVA provocation test was performed. UVA, free of sunburn radiation (50-100 J/cm2), was administered, sometimes repeatedly up to four times, to large sites of previously involved skin. With this technic the reproduction of PLE lesions under laboratory conditions was possible in 90% of this group of forty-three patients. The diagnosis was substantiated by microscopic examination of genuine and experimentally induced lesions. Characteristic histologic features of PLE are described. Phototesting with large doses of UVA aids in confirming the diagnosis of PLE. Hitherto, this diagnosis depended often on exclusion of other dermatoses. Eusolex 8021, a UVA-effective sunscreen, blocked eruptions of PLE lesions under laboratory conditions. An effective means of treatment is offered by PUVA therapy

Autofluorescence of pigmented skin lesions using a pulsed UV laser with synchronized detection: clinical results

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Cheng, Haynes P. H.; Svenmarker, Pontus; Xie, Haiyan; Tidemand-Lichtenberg, Peter; Jensen, Ole B.; Bendsoe, Niels; Svanberg, Katarina; Petersen, Paul Michael; Pedersen, Christian; Andersson-Engels, Stefan; Andersen, Peter E.

2010-04-01

We report preliminary clinical results of autofluorescence imaging of malignant and benign skin lesions, using pulsed 355 nm laser excitation with synchronized detection. The novel synchronized detection system allows high signal-tonoise ratio to be achieved in the resulting autofluorescence signal, which may in turn produce high contrast images that improve diagnosis, even in the presence of ambient room light. The synchronized set-up utilizes a compact, diode pumped, pulsed UV laser at 355 nm which is coupled to a CCD camera and a liquid crystal tunable filter. The excitation and image capture is sampled at 5 kHz and the resulting autofluorescence is captured with the liquid crystal filter cycling through seven wavelengths between 420 nm and 580 nm. The clinical study targets pigmented skin lesions and evaluates the prospects of using autofluorescence as a possible means in differentiating malignant and benign skin tumors. Up to now, sixteen patients have participated in the clinical study. The autofluorescence images, averaged over the exposure time of one second, will be presented along with histopathological results. Initial survey of the images show good contrast and diagnostic results show promising agreement based on the histopathological results.

The Impact of Quantitative Data Provided by a Multi-spectral Digital Skin Lesion Analysis Device on Dermatologists'Decisions to Biopsy Pigmented Lesions.

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Farberg, Aaron S; Winkelmann, Richard R; Tucker, Natalie; White, Richard; Rigel, Darrell S

2017-09-01

BACKGROUND: Early diagnosis of melanoma is critical to survival. New technologies, such as a multi-spectral digital skin lesion analysis (MSDSLA) device [MelaFind, STRATA Skin Sciences, Horsham, Pennsylvania] may be useful to enhance clinician evaluation of concerning pigmented skin lesions. Previous studies evaluated the effect of only the binary output. OBJECTIVE: The objective of this study was to determine how decisions dermatologists make regarding pigmented lesion biopsies are impacted by providing both the underlying classifier score (CS) and associated probability risk provided by multi-spectral digital skin lesion analysis. This outcome was also compared against the improvement reported with the provision of only the binary output. METHODS: Dermatologists attending an educational conference evaluated 50 pigmented lesions (25 melanomas and 25 benign lesions). Participants were asked if they would biopsy the lesion based on clinical images, and were asked this question again after being shown multi-spectral digital skin lesion analysis data that included the probability graphs and classifier score. RESULTS: Data were analyzed from a total of 160 United States board-certified dermatologists. Biopsy sensitivity for melanoma improved from 76 percent following clinical evaluation to 92 percent after quantitative multi-spectral digital skin lesion analysis information was provided ( p quantitative data were provided. Negative predictive value also increased (68% vs. 91%, panalysis (64% vs. 86%, p data into physician evaluation of pigmented lesions led to both increased sensitivity and specificity, thereby resulting in more accurate biopsy decisions.

Cylindrical SUV distribution model for detecting skin lesions in body trunk FDG-PET/CT images

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Nemoto, Mitsutaka; Nomura, Yukihiro; Masutani, Yoshitaka; Yoshikawa, Takeharu; Hayashi, Naoto; Yoshioka, Naoki; Ohtomo, Kuni; Hanaoka, Shouhei

2010-01-01

We have been developing a computerized detection method for skin lesions in body trunk fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT images. Spots on the skin with a high standard uptake value (SUV) are due not only to glucose metabolism in skin lesions but also to the physiological metabolism of organs near the skin. The distribution pattern of regional SUV on the skin is important information for the differential diagnosis of such high-SUV spots. In this study, we have developed a new skin lesion detection method based on a cylindrical SUV distribution model of the skin. The shape of the SUV distribution model is an approximation of the body trunk, and the SUV distribution model includes standard values for regional skin SUV. Classifier ensembles based on CT image features, SUV features, and subtraction features between the SUVs in FDG-PET images and the values in the SUV distribution model are used to extract and classify candidate regions for skin lesions. In a study of skin lesion detection using FDG-PET/CT images in 36 clinical cases, the true-positive rate was 61.7%, with 11.7 false-positive regions per case. The training results of the classifier ensemble for extracting and classifying candidate regions showed the effective features for detecting skin lesions in the study. (author)

Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

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Ayumi Korekawa

2015-07-01

Full Text Available An 81-year-old Japanese man presented with dark blue papules and nodules on his face. There were multiple soft papules and nodules, dark blue in color, compressive, and ranging in size from 2 to 10 mm. A few similar lesions were seen on the patient's right dorsal second toe and right buccal mucosa. There were no skin lesions on his trunk and upper limbs. The patient's past history did not include gastrointestinal bleeding or anemia. Histopathological examination showed dilated vascular spaces lined by the normal epithelium extending beneath the dermis and into the subcutaneous fat. Endoscopy of the gastrointestinal tract to check for colon involvement was not performed. X-ray images of the limbs revealed no abnormalities in the bones or joints. Laboratory investigations did not show anemia. Although we failed to confirm a diagnosis by endoscopy, the skin lesions, histopathological findings, lack of abnormal X-ray findings, and the presence of oral lesions as a part of gastrointestinal tract guided the diagnosis of blue rubber bleb nevus syndrome (BRBNS. Skin lesions of BRBNS occur predominantly on the trunk and upper limbs. However, the present case showed multiple skin lesions predominantly on the face. Therefore, it is important for clinicians to know about a possible atypical distribution of skin lesions in BRBNS.

Investigation of relations between skin cancer lesions' images and their fluorescent spectra

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Pavlova, P.; Borisova, E.; Avramov, L.; Petkova, El.; Troyanova, P.

2010-03-01

This investigation is based on images obtained from healthy tissue and skin cancer lesions and their fluorescent spectra of cutaneous lesions derived after optical stimulation. Our analyses show that the lesions’ spectra of are different of those, obtained from normal tissue and the differences depend on the type of cancer. We use a comparison between these “healthy” and “unhealthy” spectra to define forms of variations and corresponding diseases. However, the value of the emitted light varies not only between the patients, but also depending on the position of the tested area inside of one lesion. These variations could be result from two reasons: different degree of damaging and different thickness of the suspicious lesion area. Regarded to the visible image of the lesion, it could be connected with the chroma of colour of the tested area and the lesion homogeneity that corresponds to particular disease. For our investigation, images and spectra of three non-melanoma cutanous malignant tumors are investigated, namely—basal cell carcinoma, squamous cell carcinoma, and keratoacanthoma. The images were processed obtaining the chroma by elimination of the background—healthy tissue, and applying it as a basic signal for transformation from RGB to Lab colorimetric model. The chroma of the areas of emission is compared with the relative value of fluorescence spectra. Specific spectral features are used to develop hybrid diagnostic algorithm (including image and spectral features) for differentiation of these three kinds of malignant cutaneous pathologies.

Ectoparasites are the major causes of various types of skin lesions in small ruminants in Ethiopia.

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Chanie, Mersha; Negash, Tamiru; Sirak, Asegedech

2010-08-01

Ectoparasites are the major causes of skin lesions in animals. Clinical, skin scraping examination, and histopathological studies were conducted to identify and characterize skin lesions in small ruminants caused by ectoparasites. Mange mites, lice, sheep keds, and ticks were collected from the skin of affected animals for species identification. Skin biopsies were collected from affected part of the skin and fixed in 10% neutral buffered formalin for histopathology. Of 1,000 sheep and 600 goats examined, 815 (81.50%) sheep and 327 (54.5%) goats were infested with one or more types of ectoparasites. Sarcoptes scabiei var ovis, Demodex ovis, Psoroptes ovis, Bovicola ovis, Melophagus ovinus, and Amblyomma variegatum and other tick species were identified from sheep. S. scabiei var caprae, Demodex caprae, Linognathus stenopsis, and A. variegatum and other tick species were identified from goats. Gross skin lesions or defects observed on the skin include stained and ragged wool, loss of wool/hair, nodules, crusts, lichenification, and fissuring. Microscopic evaluation of H and E stained skin sections revealed lesions in the epidermal layer such as hyperkeratosis, acanthosis, and melanin inconsistency on the basal cells of the epidermis. Follicular keratosis, perifolliculitis, frunculosis, perivasculitis, and aggregates of inflammatory cells (of acute and chronic type) with fibrosis were experiential in the dermal layer of the skin. Most of the skin lesions caused by ectoparasites are overlapping. Thus, ectoparasites control program should be executed to reduce skin lesions as skins are the major export commodity of the country.

Factors influencing diagnostic yield of CT-guided percutaneous core needle biopsy for bone lesions

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Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

2014-01-01

Aim: To evaluate the factors influencing diagnostic yield of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for bone lesions. Materials and methods: Between September 2005 and July 2011, 162 consecutive CT-guided CNB procedures were performed in 155 patients. The variables analysed were age, sex, lesion location, lesion type, lesion size, specimen size, biopsy needle gauge, and individual radiologist. The factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were determined by multivariate analysis of variables. Results: The diagnostic yield was 81.5%. Diagnostic yield was 89.9% for lytic bone lesions and 48.5% for sclerotic bone lesions (p < 0.001), and 89.2% for lesions ≥3 cm and 73.4% for lesions <3 cm (p = 0.010). The significant factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were lesion type [p < 0.001; odds ratio (OR) for a lytic lesion was approximately 12 times higher than that for a sclerotic lesion; 95% confidence interval (CI): 4.22–34.01], and lesion size (p = 0.012; OR for a lesion size ≥3 cm was about five-times higher than that for a lesion size <3 cm; 95% CI: 1.42–16.71). Conclusion: Lesion type and lesion size are determining factors in diagnostic yield. The higher diagnostic yield is correlated with lytic lesion and lesion size ≥3 cm

Is there just one lesion? The need for whole body skin examination in patients presenting with non-melanocytic skin cancer.

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Terrill, Patricia Jane; Fairbanks, Sian; Bailey, Michael

2009-10-01

In patients presenting with non-melanoma skin cancer (NMSC) the frequency of concurrently presenting tumours is poorly documented. Whole body skin examination is recommended but in a recent survey of Australian General Practitioners and skin cancer clinics doctors it was infrequently performed. The aim of this study was to examine the incidence of concurrent skin cancer at initial presentation and therefore to examine the need for whole body skin examination for NMSC presentations. One hundred consecutive patients with a referral diagnosis indicative of NMSC were examined. Data was analysed as to the referring doctor's diagnosis, whole body skin examination findings and histology of excised lesions. Epidemiological data was obtained by patient questionnaire. One hundred patients, 41 males and 59 females, with a mean age of 70 years (range 39-91 years) underwent whole body skin examination. Sixty-seven per cent of patients were found to have additional lesions requiring treatment, 46% sin cancers (30 patients basal cell carcinomas, five squamous cell carcinomas, seven basal and squamous cell carcinomas, two lentigo maligna, two adenexal tumours) and 21% solar keratoses. Thirty-four of the additional lesions detected were in areas covered by clothing. Sixty-eight patients had a past history of skin cancer excision. In the Australian patient population, the need for whole body skin examination is essential to avoid missing concurrent lesions. Ongoing surveillance is also essential as these patients have a high risk of developing future NMSC.

DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

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Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

A comparison of arthrography to clinical diagnostics for diagnosing meniscal lesions

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Neuer, H.

1982-01-01

A comparative investigation as to the exactness of clinical and arthrographical diagnostics was carried out on 176 patients who were clinically examined and operated on in the period of 1972-1980. Using solely clinical diagnostics, the total rate of exactness was 90,9%, the exactness regarding the internal meniscal lesion being significantly higher (94.2%) than that regarding external meniscal lesion (76.7%). Using solely arthrographic diagnostics, the total rate of exactness was 82%, the rate for internal meniscus being significantly lower (83.9%) than that obtained using clinical diagnostics. As for the external meniscus, the exactness of arthrography differs only slightly from clinical diagnostics with 74.7%. The most frequent sources of error in arthorgraphy were found to be lesions of the posterior horn at the internal meniscus. In cases of external meniscal lesions, especially when an internal meniscal lesion was existing at the same time, both examination methods failed in 5 cases. For routine diagnosing of meniscal lesions, arthrography is not necessary. An accurate clinical examination and anamnesis bring very good and exact results and should therefore be given absolute priority. (orig./MG) [de

Image quality enhancement for skin cancer optical diagnostics

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Bliznuks, Dmitrijs; Kuzmina, Ilona; Bolocko, Katrina; Lihachev, Alexey

2017-12-01

The research presents image quality analysis and enhancement proposals in biophotonic area. The sources of image problems are reviewed and analyzed. The problems with most impact in biophotonic area are analyzed in terms of specific biophotonic task - skin cancer diagnostics. The results point out that main problem for skin cancer analysis is the skin illumination problems. Since it is often not possible to prevent illumination problems, the paper proposes image post processing algorithm - low frequency filtering. Practical results show diagnostic results improvement after using proposed filter. Along that, filter do not reduces diagnostic results' quality for images without illumination defects. Current filtering algorithm requires empirical tuning of filter parameters. Further work needed to test the algorithm in other biophotonic applications and propose automatic filter parameter selection.

HLA-DPDQDR is expressed in all lesional skin from patients with autoimmune skin diseases

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Ana Maria Abreu Velez

2014-04-01

Full Text Available Introduction: Human genes responsible for human antigen presentation and transplant rejection functions are located on the short arm of Chromosome 6 and are called the Major Histocompatibility Complex (MHC. Moreover, the primary physiologic function of MHC molecules is to present peptides to T lymphocytes. MHC molecules are integral components of the ligands that most T cells recognize, since the T cell receptor (TCR has specificity for complexes of foreign antigenic peptides, as well as self-MHC molecules. Aim: Our investigation attempts to investigate the presence of HLA-DPDQDR within lesional skin biopsies from patients affected by autoimmune skin blistering diseases (ABDs. Materials and Methods: We utilized immunohistochemistry (IHC to evaluate the presence of HLA-DPDQDR in lesional skin biopsies of patients affected by ABDs. We tested 30 patients with endemic pemphigus foliaceus (EPF, 15 controls from the EPF endemic area, and 15 biopsies from healthy controls from the USA. We also tested archival biopsies from patients with selected ABDs, including 30 patients with bullous pemphigoid (BP, 20 with pemphigus vulgaris (PV, 8 with pemphigus foliaceus (PF, 14 with dermatitis herpetiformis (DH and 2 with epidermolysis bullosa acquisita (EBA. Results: Most ABD biopsies stained positive for HLA-DPDQDR in the lesional blisters and/or inflamed neurovascular plexus in the superficial dermis, and also at mesenchymal-endothelial like-cell junctions in the dermis. In BP, EBA and EPF, the HLA-DPDQDR staining was also seen in the dermal eccrine sweat gland coils and and ducts. Conclusion: Here, we document that HLA-DPDQDR is expressed in several anatomic areas of lesional skin in patients with ABDs. Notably, HLA-DPDQDR positivity was also consistently present in areas of the classic immune response in pemphigus epidermal keratinocytic intercellular junctions, and at basement membrane sites in bullous pemphigoid and other subepidermal blistering diseases.

MR imaging diagnostic protocol for unilocular lesions of the jaw

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Hironobu Konouchi

2012-08-01

Using our MR imaging diagnostic protocol to diagnose 31 cases, we obtained a positivity rate of 71.0%. The use of our MR imaging diagnostic protocol for unilocular lesions, which are especially difficult to differentiate by radiography, would improve the morphological and qualitative diagnosis of soft tissue lesions.

Social networks of patients with chronic skin lesions: nursing care.

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Bandeira, Luciana Alves; Santos, Maxuel Cruz Dos; Duarte, Êrica Rosalba Mallmann; Bandeira, Andrea Gonçalves; Riquinho, Deise Lisboa; Vieira, Letícia Becker

2018-01-01

To describe the social networks of patients with chronic skin damages. A qualitative study conducted through semi-structured interviews with nine subjects with chronic skin lesions from June 2016 to March 2017; we used the theoretical-methodological framework of Lia Sanicola's Social Network. The analysis of the relational maps revealed that the primary network was formed mainly by relatives and neighbors; its characteristics, such as: reduced size, low density and few exchanges/relationships, configures fragility in these links. The secondary network was essentially described by health services, and the nurse was cited as a linker in the therapeutic process. Faced with the fragility of the links and social isolation, the primary health care professionals are fundamental foundations for the construction of networks of social support and care for patients with chronic skin lesions.

A 28-Year-Old Male Patient with Nail Tumors, Skin Lesions, and Epilepsy.

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Balak, Deepak M W; Zonnenberg, Bernard A; Spitzer-Naaijkens, Juliette M J; Hulshof, Mieke M

2017-01-01

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by the development of benign hamartomas in multiple organs. Most patients with TSC exhibit cutaneous manifestations. We report a 28-year-old patient with multiple pink papules at the proximal nail fold of several toes. Histopathological analysis of a biopsy of a papule was consistent with an ungual fibroma. Histopathological analysis of a biopsy of an elevated skin-colored plaque at the lower back was diagnostic for a Shagreen patch. These findings were consistent with a clinical diagnosis of TSC. This patient was subsequently referred to a multidisciplinary TSC clinic for further screening, which revealed a giant cell astrocytoma and multiple subependymal tubers. Annual monitoring was recommended. The skin lesions were treated with topical rapamycin ointment. Recognizing dermatological manifestations of TSC is of importance to allow early diagnosis. TSC should be considered as a differential diagnosis in the case of ungual fibromas, even in older patients.

A 28-Year-Old Male Patient with Nail Tumors, Skin Lesions, and Epilepsy

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Deepak M.W. Balak

2017-01-01

Full Text Available Background: Tuberous sclerosis complex (TSC is an autosomal dominant disorder characterized by the development of benign hamartomas in multiple organs. Most patients with TSC exhibit cutaneous manifestations. Methods: We report a 28-year-old patient with multiple pink papules at the proximal nail fold of several toes. Results: Histopathological analysis of a biopsy of a papule was consistent with an ungual fibroma. Histopathological analysis of a biopsy of an elevated skin-colored plaque at the lower back was diagnostic for a Shagreen patch. These findings were consistent with a clinical diagnosis of TSC. This patient was subsequently referred to a multidisciplinary TSC clinic for further screening, which revealed a giant cell astrocytoma and multiple subependymal tubers. Annual monitoring was recommended. The skin lesions were treated with topical rapamycin ointment. Conclusions: Recognizing dermatological manifestations of TSC is of importance to allow early diagnosis. TSC should be considered as a differential diagnosis in the case of ungual fibromas, even in older patients.

Communicating the location of potential skin neoplasms for excision between the referring and the operating doctor--an audit of skin lesion referrals in Whanganui, New Zealand.

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Welsh, Fraser; Bullen, Naomi; Aiono, Semisi

2013-08-30

The importance of correctly defining the location of potential skin cancer when surgical treatment may be required is self-evident. Clear communication is essential if the professional diagnosing potential skin cancer is not the same professional providing treatment. We aimed to assess the nature of the localising information provided in referrals to the local anaesthetic skin lesion theatre in our institution. Information localising target lesions for new patients seen in our local anaesthetic skin excision theatre was recorded during a 2-month period April to May 2012 inclusive 100 patients were seen in our skin excision theatre during the study period; 16 patients were not able to identify the target skin lesion at the time they entered the operating theatre. The target lesion could not be determined from the referral text in 30/100 cases. Diagrams were provided in 19/100 cases. Photographs were provided in 3/100 cases. Pictorial and photographic means of communicating the location of suspicious lesions are under-utilised in our service. Relying on the patient or the referral text to correctly identify the lesion leaves considerable room for error. We suggest that photographic information for skin lesion referrals is adopted as a minimum standard.

Bone marrow lesions: A systematic diagnostic approach

International Nuclear Information System (INIS)

Grande, Filippo Del; Farahani, Sahar J; Carrino, John A; Chhabra, Avneesh

2014-01-01

Bone marrow lesions on magnetic resonance (MR) imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI), to achieve accurate final diagnosis has been highlighted

Prevalence of Oral, Skin, and Oral and Skin Lesions of Lichen Planus in Patients Visiting a Dental School in Southern India

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Omal, PM; Jacob, Vimal; Prathap, Akhilesh; Thomas, Nebu George

2012-01-01

Background: Lichen planus (LP) is a mucocutaneous disease that is relatively common among adult population. LP can present as skin and oral lesions. This study highlights the prevalence of oral, skin, and oral and skin lesions of LP. Aims: The aim of this study was to evaluate the prevalence of oral, skin, and oral and skin lesions of LP from a population of patients attending the Department of Oral Medicine and Radiodiagnosis, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India. Materials and Methods: A cross-sectional study was designed to evaluate the prevalence of oral, skin, and oral and skin lesions of LP. This is a ongoing prospective study with results of 2 years being reported. LP was diagnosed on the basis of clinical presentation and histopathological analysis of mucosal and skin biopsy done for all patients suspected of having LP. Statistical analysis was carried out using SPSS (Statistical package for social sciences) software version 14. To test the statistical significance, chi-square test was used. Results: Out of 18,306 patients screened, 8,040 were males and 10,266 females. LP was seen in 118 cases (0.64%). Increased prevalence of LP was observed in middle age adults (40–60 years age group) with lowest age of 12 years and highest age of 65 years. No statistically significant differences were observed between the genders in skin LP group (P=0.12) and in oral and skin LP groups (P=0.06); however, a strong female predilection was seen in oral LP group (P=0.000036). The prevalence of cutaneous LP in oral LP patients was 0.06%. Conclusion: This study showed an increased prevalence of oral LP than skin LP, and oral and skin LP with a female predominance. PMID:22615505

Social networks of patients with chronic skin lesions: nursing care

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Luciana Alves Bandeira

Full Text Available ABSTRACT Objective: To describe the social networks of patients with chronic skin damages. Method: A qualitative study conducted through semi-structured interviews with nine subjects with chronic skin lesions from June 2016 to March 2017; we used the theoretical-methodological framework of Lia Sanicola’s Social Network. Results: The analysis of the relational maps revealed that the primary network was formed mainly by relatives and neighbors; its characteristics, such as: reduced size, low density and few exchanges/relationships, configures fragility in these links. The secondary network was essentially described by health services, and the nurse was cited as a linker in the therapeutic process. Final considerations: Faced with the fragility of the links and social isolation, the primary health care professionals are fundamental foundations for the construction of networks of social support and care for patients with chronic skin lesions.

Predicting risk of nonmelanoma skin cancer and premalignant skin lesions in renal transplant recipients.

Science.gov (United States)

Urwin, Helen R; Jones, Peter W; Harden, Paul N; Ramsay, Helen M; Hawley, Carmel M; Nicol, David L; Fryer, Anthony A

2009-06-15

Nonmelanoma skin cancer (NMSC) and associated premalignant lesions represent a major complication after transplantation, particularly in areas with high ultraviolet radiation (UVR) exposure. The American Society of Transplantation has proposed annual NMSC screening for all renal transplant recipients. The aim of this study was to develop a predictive index (PI) that could be used in targeted screening. Data on patient demographics, UVR exposure, and other clinical parameters were collected on 398 adult recipients recruited from the Princess Alexandra Hospital, Brisbane. Structured interview, skin examination, biopsy of lesions, and review of medical/pathologic records were performed. Time to presentation with the first NMSC was assessed using Cox's regression models and Kaplan-Meier estimates used to assess detection of NMSC during screening. Stepwise selection identified age, outdoor UVR exposure, living in a hot climate, pretransplant NMSC, childhood sunburning, and skin type as predictors. The PI generated was used to allocate patients into three screening groups (6 months, 2 years, and 5 years). The survival curves of these groups were significantly different (PPI to enable development of targeted NMSC surveillance strategies.

Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

Science.gov (United States)

Vigneswaran, Nadarajah

2011-03-01

Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

International Nuclear Information System (INIS)

Fatmi, Zafar; Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar

2009-01-01

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons ≥15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among ≥15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI 2 . Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further investigations and

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

Energy Technology Data Exchange (ETDEWEB)

Fatmi, Zafar, E-mail: zafar.fatmi@aku.edu [Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi (Pakistan); Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar [Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi (Pakistan)

2009-07-15

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons {>=}15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among {>=}15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI <18.5 kg/m{sup 2}. Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

Science.gov (United States)

Fatmi, Zafar; Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar

2009-07-01

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons > or = 15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among > or = 15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI <18.5 kg/m2. Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further

Clinical confrontation results of diagnostics and treatment of skin cancer

International Nuclear Information System (INIS)

Zikiryakhodjaev, D.Z.; Sanginov, D.R.

2001-01-01

In this chapter of book authors investigated the clinical confrontation results of diagnostics and treatment of skin cancer. They noted that diagnostic of skin cancer have to foresee the determination morphologic implements and degree of malignancy tumorous process why in general depend prognosis of illness

Bone marrow lesions: A systematic diagnostic approach

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Filippo Del Grande

2014-01-01

Full Text Available Bone marrow lesions on magnetic resonance (MR imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI, to achieve accurate final diagnosis has been highlighted.

Artefactual skin lesions in children and adolescents

DEFF Research Database (Denmark)

Ring, Hans Christian; Miller, Iben M; Benfeldt, Eva

2015-01-01

BACKGROUND: Self harm is a great diagnostic and treatment challenge. In addition, psychocutaneous conditions are rare in the pediatric population and may therefore be misdiagnosed. Dermatitis artefacta is a psychocutaneous syndrome, which is a subgroup of the general spectrum of self-inflicted skin...

Open season: select the best 'beast' for each skin lesion.

Science.gov (United States)

Uber, Marjorie; Robl, Renata; Carvalho, Vania Oliveira; Abagge, Kerstin Taniguchi; Valério, Talita Sana; Marinoni, Leide Parolin; Cosechen Rosvailer, Mayara Schulze

2015-10-01

Animal bites can cause skin lesions that suggest other conditions, and therefore diagnosis can be a challenge. Four cases of skin injuries caused by arthropods are presented below. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Epidemiological investigation of tattoo-like skin lesions among bottlenose dolphins in Shark Bay, Australia.

Science.gov (United States)

Powell, Sarah N; Wallen, Megan M; Bansal, Shweta; Mann, Janet

2018-07-15

Bottlenose dolphins are excellent bioindicators of ocean ecosystem health for three reasons: (a) as long-lived apex predators they accumulate biotoxins and contaminants; (b) they are visible, routinely appearing at the water's surface in coastal areas, often coming into close contact with humans; and, (c) they exhibit a range of pathogenic lesions attributable to environmental degradation. In this study, we analyzed tattoo-like skin lesions in a population of Tursiops aduncus studied for 30+years in Shark Bay, Australia, a UNESCO World Heritage Site. We provide important baseline data by documenting epidemiological patterns of tattoo-like skin lesions in a healthy, free-ranging population that builds on the previous data of tattoo skin disease (TSD) derived from free ranging, stranded, and dead dolphins. Individual dolphins were classified as symptomatic with tattoo-like skin disease if at least one photograph showed a lesion similar to TSD. The average age of infection was 26.6months (±34.8months) with the symptomatic period lasting 137±29.8days. Overall prevalence of tattoo-like skin disease in the population was 19.4%. Age, but not sex, was significant, with yearlings (1-2years) exhibiting tattoo-like lesions more than younger and older calves. Tattoo-like lesions were rare among juvenile and adult dolphins (N=68 calves, 4 juveniles, and 3 adults). We hypothesize that the lower prevalence in youngest calves (2years) have infection-acquired immunity, as reported for other small cetaceans. The low prevalence of tattoo-like lesions in Shark Bay compared to other populations with poxvirus is consistent with reproductive and demographic viability analyses. Furthermore, by documenting the demography of the disease, we can monitor changes in the prevalence of tattoo-like lesions as a sentinel indicator of ecosystem health. Copyright © 2018 Elsevier B.V. All rights reserved.

Survey on the importance of mange in the aetiology of skin lesions in goats in Peninsular Malaysia.

Science.gov (United States)

Dorny, P; Van Wyngaarden, T; Vercruysse, J; Symoens, C; Jalia, A

1994-05-01

A survey on mange mite infestations in the aetiology of skin lesions in goats in Peninsular Malaysia is described. Skin lesions were observed in 25 (93%) of the 27 goat farms investigated. Mange mites were found in 22 (88%) of these goat herds. Chorioptes texanus was found in 20.7%, Psoroptes cuniculi in 19.3%, Sarcoptes scabiei in 18.6% and Demodex canis var. caprae in 0.4% of the samples, taken from the skin lesions. Thirteen cases of generalised manage were diagnosed, from which 9 were caused by S. scabiei, 2 by P. cuniculi and one by C. texanus. All other cases had more or less localised lesions. No significant differences could be found in incidence and distribution of skin lesions between age classes.

Influence of social mixing and group size on skin lesions and mounting in organic entire male pigs

DEFF Research Database (Denmark)

Thomsen, Rikke; Edwards, Sandra A; Rousing, Tine

2016-01-01

in management procedures and production system might be needed. Elements from the organic pig production system might be beneficial in this aspect. The aim of this article is to investigate the effect of grouping strategy including social mixing and group size on levels of mounting behaviour and skin lesions...... at weaning. A second mixing occurred at insertion to fattening pens for pigs being regrouped. Counting of skin lesions (1348 or 1124 pigs) and registration of mounting behaviour (1434 or 1258 pigs) were done on two occasions during the experimental period. No interactive effects were found between social...... mixing and group size on either skin lesions or mounting frequency. Herd differences were found for both mounting frequency and number of skin lesions. No association between skin lesions and mounting were revealed. Social mixing and group size were shown as interacting effects with herds on mounting...

Association of AS3MT polymorphisms and the risk of premalignant arsenic skin lesions

International Nuclear Information System (INIS)

Valenzuela, Olga L.; Drobna, Zuzana; Hernandez-Castellanos, Erika; Sanchez-Pena, Luz C.; Garcia-Vargas, Gonzalo G.; Borja-Aburto, Victor H.; Styblo, Miroslav; Del Razo, Luz M.

2009-01-01

Exposure to naturally occurring inorganic arsenic (iAs), primarily from contaminated drinking water, is considered one of the top environmental health threats worldwide. Arsenic (+3 oxidation state) methyltransferase (AS3MT) is the key enzyme in the biotransformation pathway of iAs. AS3MT catalyzes the transfer of a methyl group from S-adenosyl-L-methionine to trivalent arsenicals, resulting in the production of methylated (MAs) and dimethylated arsenicals (DMAs). MAs is a susceptibility factor for iAs-induced toxicity. In this study, we evaluated the association of the polymorphism in AS3MT gene with iAs metabolism and with the presence of arsenic (As) premalignant skin lesions. This is a case-control study of 71 cases with skin lesions and 51 controls without skin lesions recruited from a iAs endemic area in Mexico. We measured urinary As metabolites, differentiating the trivalent and pentavalent arsenical species, using the hydride generation atomic absorption spectrometry. In addition, the study subjects were genotyped to analyze three single nucleotide polymorphisms (SNPs), A-477G, T14458C (nonsynonymus SNP; Met287Thr), and T35587C, in the AS3MT gene. We compared the frequencies of the AS3MT alleles, genotypes, and haplotypes in individuals with and without skin lesions. Marginal differences in the frequencies of the Met287Thr genotype were identified between individuals with and without premalignant skin lesions (p = 0.055): individuals carrying the C (TC+CC) allele (Thr) were at risk [odds ratio = 4.28; 95% confidence interval (1.0-18.5)]. Also, individuals with C allele of Met287Thr displayed greater percentage of MAs in urine and decrease in the percentage of DMAs. These findings indicate that Met287Thr influences the susceptibility to premalignant As skin lesions and might be at increased risk for other adverse health effects of iAs exposure.

Molecular characterization of poxviruses associated with tattoo skin lesions in UK cetaceans.

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Barbara A Blacklaws

Full Text Available There is increasing concern for the well-being of cetacean populations around the UK. Tattoo skin disease (characterised by irregular, grey, black or yellowish, stippled cutaneous lesions caused by poxvirus infection is a potential health indicatora potential health indicator for cetaceans. Limited sequence data indicates that cetacean poxviruses (CPVs belong to an unassigned genus of the Chordopoxvirinae. To obtain further insight into the phylogenetic relationships between CPV and other Chordopoxvirinae members we partially characterized viral DNA originating from tattoo lesions collected in Delphinidae and Phocoenidae stranded along the UK coastline in 1998-2008. We also evaluated the presence of CPV in skin lesions other than tattoos to examine specificity and sensitivity of visual diagnosis. After DNA extraction, regions of the DNA polymerase and DNA topoisomerase I genes were amplified by PCR, sequenced and compared with other isolates. The presence of CPV DNA was demonstrated in tattoos from one striped dolphin (Stenella coeruleoalba, eight harbour porpoises (Phocoena phocoena and one short-beaked common dolphin (Delphinus delphis and in one 'dubious tattoo' lesion detected in one other porpoise. Seventeen of the 18 PCR positive skin lesions had been visually identified as tattoos and one as a dubious tattoo. None of the other skin lesions were PCR positive. Thus, visual identification had a 94.4% sensitivity and 100% specificity. The DNA polymerase PCR was most effective in detecting CPV DNA. Limited sequence phylogeny grouped the UK samples within the odontocete poxviruses (CPV group 1 and indicated that two different poxvirus lineages infect the Phocoenidae and the Delphinidae. The phylogenetic tree had three major branches: one with the UK Phocoenidae viruses, one with the Delphinidae isolates and one for the mysticete poxvirus (CPV group 2. This implies a radiation of poxviruses according to the host suborder and the families within

Occupational skin cancer and precancer

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Fifinela Raissa

2016-12-01

Full Text Available Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit, ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of the skin are actinic keratosis and Bowen’s disease. Particular diagnostic criteria to diagnose occupational diseases has been developed. Early detection of occupational skin cancer and precancerous lesion is necessary. An effective prevention program consists of primary prevention such as prevention of hazardous material exposure, secondary prevention such as early detection of disease for early intervention, and tertiary prevention such as minimizing long-term impact of the disease.

DIAGNOSTIC UTILITY OF USG-GUIDED FNAC IN HEPATIC LESIONS

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Sudha P. Meena

2016-06-01

Full Text Available INTRODUCTION Guided fine-needle aspiration cytology (FNAC is an easy, rapid, minimally invasive and a cost effective diagnostic method for detecting benign and malignant lesions of liver. AIM The main aim of the present study was to establish the incidence of various hepatic lesions and to find out adequacy and utility of the procedure. MATERIAL AND METHOD A total of 174 cases were included in the study from Government Medical College, Kota and associated hospitals. All cases diagnosed to have single or multiple hepatic mass lesions on USG were included in the study. RESULTS Most common age group affected by hepatic lesion was 51-60 years (34.0%. 91.4% cases were having adequate aspirates. 95.6% of the total diagnosed cases were malignant and among malignant cases majority were metastatic. CONCLUSION USG-guided FNAC is a very useful procedure in the diagnosis of hepatic lesions as the procedure is simple and safe. Thus, FNAC is a simple and effective diagnostic tool in our hand.

Fluoroscopically guided automated gun biopsy of chest lesions: diagnostic accuracy and complications

International Nuclear Information System (INIS)

Oh, Hee Sul; Han, Young Min; Choi, Ki Chul and others

1998-01-01

To determine the diagnostic accuracy and frequency of complications of fluoroscopyguided transthoracic needle biopsy, using an automated gun biopsy system. We retrospectively reviewed 86 patients who underwent automated gun biopsy between October 1995 and October 1996. An 18-gauge cutting needle was used in all cases. All biopsies were performed under fluoroscopic guidance by one interventional radiologist. Tissue sufficient for histologic diagnosis was obtained in 73 of 86 biopsies(84.9%). Fifty-six lesions were malignent and 30 were benign. Sensitivity and diagnostic accuracy for malignant lesions were 87.5% and 87.5%, respectively while cell type specificity in malignant diagnosis was 91.7%(11/12). Sensitivity and diagnostic accuracy for benign lesions were 80.0% and 73.3%, respectively. Postbioptic pneumothorax occurred in three of 86 biopsies(3.5%), one of which required placement of a chest tube. Automated gun biopsy is a simple, safe method for the diagnosis of focal chest lesions. An automated biopsy device offers high diagnostic accuracy in casis involving malignant and benign lesions of the chest, and is particularly useful for determining malignant cell type and specific diagnosis of benign lesions.=20

Artefactual skin lesions in children and adolescents: review of the literature and two cases of factitious purpura.

Science.gov (United States)

Ring, Hans Christian; Miller, Iben M; Benfeldt, Eva; Jemec, Gregor B E

2015-01-01

Self harm is a great diagnostic and treatment challenge. In addition, psychocutaneous conditions are rare in the pediatric population and may therefore be misdiagnosed. Dermatitis artefacta is a psychocutaneous syndrome, which is a subgroup of the general spectrum of self-inflicted skin lesions. Dermatitis artefacta encompasses an array of different clinical manifestations, including purpura. Factitious purpura has rarely been reported in children. Case report and review of the literature. We describe two Caucasian patients (9-year-old boy and 10-year-old girl) with striking purpuric lesions diagnosed as factitious purpura. The clinical lesions were similar, but the underlying psychological problems differed significantly (depression and stress). The current state of knowledge of dermatitis artefacta in children and adolescents was reviewed. The presence of purpura in children and adolescents typically causes extensive intervention programs due to the possible serious pathological consequences. The two cases demonstrate a need for a high degree of attention to psychological disturbances, lesional evolution, and distribution once the suspicion is established. © 2014 The International Society of Dermatology.

Simulators of Squamous Cell Carcinoma of the Skin: Diagnostic Challenges on Small Biopsies and Clinicopathological Correlation

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Kong-Bing Tan

2013-01-01

Full Text Available Squamous cell carcinoma (SCC is a common and important primary cutaneous malignancy. On skin biopsies, SCC is characterized by significant squamous cell atypia, abnormal keratinization, and invasive features. Diagnostic challenges may occasionally arise, especially in the setting of small punch biopsies or superficial shave biopsies, where only part of the lesion may be assessable by the pathologist. Benign mimics of SCC include pseudoepitheliomatous hyperplasia, eccrine squamous syringometaplasia, inverted follicular keratosis, and keratoacanthoma, while malignant mimics of SCC include basal cell carcinoma, melanoma, and metastatic carcinoma. The careful application of time-honored diagnostic criteria, close clinicopathological correlation and a selective request for a further, deeper, or wider biopsy remain the most useful strategies to clinch the correct diagnosis. This review aims to present the key differential diagnoses of SCC, to discuss common diagnostic pitfalls, and to recommend ways to deal with diagnostically challenging cases.

Radiation-induced vascular lesions of the skin: an overview

NARCIS (Netherlands)

Flucke, U.E.; Requena, L.; Mentzel, T.

2013-01-01

Radiation-induced cutaneous vascular neoplasms occur infrequently and comprise benign, so-called atypical vascular lesions (AVL) and angiosarcomas (AS), often being high-grade malignant tumors. Both arise most frequently within previously irradiated skin in breast-conserving-treated mammary cancer

Stokes polarimetry probe for skin lesion evaluation: preliminary results

Science.gov (United States)

Louie, Daniel C.; Tchvialeva, Lioudmilla; Kalia, Sunil; Lui, Harvey; Lee, Tim K.

2018-02-01

This paper reports on the design of a prototype in-vivo Stokes polarimetry probe for skin lesion evaluation, and preliminary results from skin phantom and clinical trials of this device. The probe releases a single millisecond-long pulse from a laser diode with either linear or circular polarization. It then captures the resulting backscattered far-field polarization speckle and calculates the Stokes parameters. This probe was designed with three novel innovations in mind. First, the Stokes vector is captured quickly, using low-cost components without the use of moving parts. Second, a compact collimated laser diode was used as the light source. Third, the device and detector geometry were designed to produce and capture a uniform speckle field. In the first clinical trial of this device, measurements were taken from a variety of skin lesions, both cancerous and benign. The Stokes vector was measured and used to calculate the degree of polarization (DOP), the azimuth angle, and the ellipticity angle of the polarization ellipse for two input light polarizations. Among other findings, the DOP for circular polarized input light was consistently lower than the DOP for linear polarized input light. These findings indicate the potential for a fast and low-cost in-vivo skin cancer screening tool, and encourages the continuing development of this probe's techniques.

Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions.

Science.gov (United States)

Makris, D; Scherpereel, A; Leroy, S; Bouchindhomme, B; Faivre, J-B; Remy, J; Ramon, P; Marquette, C-H

2007-06-01

The present study prospectively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy, for small peripheral lung lesions in patients where standard techniques were nondiagnostic. The study was conducted in a tertiary medical centre on 40 consecutive patients considered unsuitable for straightforward surgery or computed tomography (CT)-guided transthoracic needle aspiration biopsy, due to comorbidities. The lung lesion diameter was mean+/-sem 23.5+/-1.5 mm and the depth from the visceral-costal pleura was 14.9+/-2 mm. Navigation was facilitated by an electromagnetic tracking system which could detect a position sensor incorporated into a flexible catheter advanced through a bronchoscope. Information obtained during bronchoscopy was superimposed on previously acquired CT data. Divergence between CT data and data obtained during bronchoscopy was calculated by the system's software as a measure of navigational accuracy. All but one of the target lesions was reached and the overall diagnostic yield was 62.5% (25-40). Diagnostic yield was significantly affected by CT-to-body divergence; yield was 77.2% when estimated divergence was drainage was required in one case. Electromagnetic navigation-guided bronchoscopy has the potential to improve the diagnostic yield of transbronchial biopsies without additional fluoroscopic guidance, and may be useful in the early diagnosis of lung cancer, particularly in nonoperable patients.

Defects of filaggrin-like proteins in both lesional and nonlesional atopic skin.

Science.gov (United States)

Pellerin, Laurence; Henry, Julie; Hsu, Chiung-Yueh; Balica, Stéfana; Jean-Decoster, Catherine; Méchin, Marie-Claire; Hansmann, Britta; Rodriguez, Elke; Weindinger, Stefan; Schmitt, Anne-Marie; Serre, Guy; Paul, Carle; Simon, Michel

2013-04-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by a disturbed epidermal barrier. In a subset of patients, this is explained by nonsense mutations in the gene encoding filaggrin (FLG). We sought to evaluate the respective role of FLG mutations and proinflammatory cytokines and to assess the expression of FLG, hornerin (HRNR), and FLG2, 2 FLG-like proteins, which are involved in epidermal barrier functions, in normal skin and both lesional and nonlesional skin of patients with AD. An FLG-genotyped cohort of 73 adults with AD and 73 aged-matched control subjects was analyzed by using immunohistochemistry and immunoblotting. Normal primary human keratinocytes were differentiated in either the absence or presence of IL-4, IL-13, and IL-25. Compared with control subjects, FLG, HRNR, and FLG2 were detected at significantly lower levels in the skin of patients with AD, irrespective of their FLG genotype. The reduction was greater in lesional compared with nonlesional skin. In addition, the proFLG/FLG ratio was found to be higher in the skin of wild-type patients than in control subjects. Cytokine treatment of keratinocytes induced a dramatic reduction in FLG, FLG2, and HRNR expression both at the mRNA and protein levels. The stratum corneum of lesional but also clinically unaffected skin of adults with AD is abnormal, with reduced expression of FLG and FLG-like proteins. In addition to nonsense mutations, proinflammatory cytokines and some defects in the proFLG processing can contribute to the FLG downregulation. Our study suggests that skin inflammation reduces the expression of FLG-like proteins, contributing to the AD-related epidermal barrier dysfunction. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Comparison of SPECT/CT and MRI in diagnosing symptomatic lesions in ankle and foot pain patients: diagnostic performance and relation to lesion type.

Science.gov (United States)

Ha, Seunggyun; Hong, Sung Hwan; Paeng, Jin Chul; Lee, Dong Yeon; Cheon, Gi Jeong; Arya, Amitabh; Chung, June-Key; Lee, Dong Soo; Kang, Keon Wook

2015-01-01

The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types. Fifty consecutive patients with ankle and foot pain, who underwent 99mTc-MDP SPECT/CT and MRI, were retrospectively enrolled in this study. Symptomatic lesions were determined based on clinical examination and response to treatment. On MRI and SPECT/CT, detected lesions were classified as bone, ligament/tendon, and joint lesions. Uptake on SPECT/CT was assessed using a 4-grade system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT/CT and MRI were evaluated in all detected lesions and each lesion type. Diagnostic value of uptake grade was analyzed using receiver-operating characteristics (ROC) curve analysis, and diagnostic performance was compared using Chi-square or McNemar tests. In overall lesions, the sensitivity, PPV and NPV of SPECT/CT for symptomatic lesions were 93%, 56%, 91%, and they were 98%, 48%, 95% for MRI. There was no significant difference between SPECT/CT and MRI. However, the specificity of SPECT/CT was significantly higher than that of MRI (48% versus 24%, P = 0.016). Uptake grade on SPECT/CT was significantly higher in symptomatic lesions (P diagnostic performance for symptomatic lesions in ankle and foot pain patients. SPECT/CT and MRI exhibit different diagnostic specificity in different lesion types. SPECT/CT may be used as a complementary imaging method to MRI for enhancing diagnostic specificity.

A Prospective Study of Arsenic Exposure From Drinking Water and Incidence of Skin Lesions in Bangladesh

Science.gov (United States)

Argos, Maria; Kalra, Tara; Pierce, Brandon L.; Chen, Yu; Parvez, Faruque; Islam, Tariqul; Ahmed, Alauddin; Hasan, Rabiul; Hasan, Khaled; Sarwar, Golam; Levy, Diane; Slavkovich, Vesna; Graziano, Joseph H.; Rathouz, Paul J.; Ahsan, Habibul

2011-01-01

Elevated concentrations of arsenic in groundwater pose a public health threat to millions of people worldwide. The authors aimed to evaluate the association between arsenic exposure and skin lesion incidence among participants in the Health Effects of Arsenic Longitudinal Study (HEALS). The analyses used data on 10,182 adults free of skin lesions at baseline through the third biennial follow-up of the cohort (2000–2009). Discrete-time hazard regression models were used to estimate hazard ratios and 95% confidence intervals for incident skin lesions. Multivariate-adjusted hazard ratios for incident skin lesions comparing 10.1–50.0, 50.1–100.0, 100.1–200.0, and ≥200.1 μg/L with ≤10.0 μg/L of well water arsenic exposure were 1.17 (95% confidence interval (CI): 0.92, 1.49), 1.69 (95% CI: 1.33, 2.14), 1.97 (95% CI: 1.58, 2.46), and 2.98 (95% CI: 2.40, 3.71), respectively (Ptrend = 0.0001). Results were similar for the other measures of arsenic exposure, and the increased risks remained unchanged with changes in exposure in recent years. Dose-dependent associations were more pronounced in females, but the incidence of skin lesions was greater in males and older individuals. Chronic arsenic exposure from drinking water was associated with increased incidence of skin lesions, even at low levels of arsenic exposure (<100 μg/L). PMID:21576319

Polymorphisms in XPD (Asp312Asn and Lys751Gln) genes, sunburn and arsenic-related skin lesions.

Science.gov (United States)

McCarty, Kathleen M; Smith, Thomas J; Zhou, Wei; Gonzalez, Ernesto; Quamruzzaman, Quazzi; Rahman, Mahmuder; Mahiuddin, Golam; Ryan, Louise; Su, Li; Christiani, David C

2007-08-01

Single-nucleotide polymorphisms in genes related to DNA repair capacity and ultraviolet exposure have not been well investigated in relation to skin lesions associated with arsenic exposure. This population based case-control study, of 600 cases and 600 controls, frequency matched on age and gender in Pabna, Bangladesh, in 2001-2002, investigated the association and potential effect modification between polymorphisms in Xeroderma Pigmentosum complementation group D (XPD) (Lys751Gln and Asp312Asn) genes, tendency to sunburn and arsenic-related skin lesions. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). No significant association was observed between skin lesions and the XPD 312 Asp/Asn (adjusted OR = 0.87, 95% CI = 0.65-1.15) Asn/Asn (adjusted OR = 0.76, 95% CI = 0.50-1.15) (referent Asp/Asp); XPD 751 Lys/Gln (adjusted OR = 0.92, 95% CI = 0.69-1.23) Gln/Gln (adjusted OR = 0.98, 95% CI = 0.66-1.45) (referent Lys/Lys). While we did not observe any evidence of effect modification of these polymorphisms on the association between well arsenic concentration and skin lesions, we did observe effect modification between these polymorphisms and sunburn tendency and arsenic-related skin lesions. Individuals with the heterozygote or homozygote variant forms (Asp/Asn or Asn/Asn) had half the risk of skin lesions (OR = 0.45, 95% CI = 0.29-0.68) compared with those with the wild-type XPDAsp312Asn genotype (Asp/Asp) and individuals with heterozygote or homozygote variant forms (Lys/Gln or Gln/Gln) had half the risk of skin lesions (OR = 0.47, 95% CI = 0.31-0.72) compared with those with the wild-type XPDLys751Gln genotype (Lys/Lys), within the least sensitive strata of sunburn severity. We observed effect modification on the multiplicative scale for XPD 751 and XPD 312. XPD polymorphisms modified the relationship between tendency to sunburn and skin lesions in an arsenic exposed population. Further study is necessary

Aeromonas hydrophila-associated skin lesions and septicaemia in a Nile crocodile (Crocodylus niloticus : clinical communication

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H. Turutoglu

2005-06-01

Full Text Available Aeromonas hydrophila is one of the most common bacteria associated with the aquatic environment. There are , however, limited data on A. hydrophila infection in crocodilians. The aim of this report is to describe a case of skin lesions and septicaemia associated with A. hydrophila in a Nile crocodile (Crocodylus niloticus. A captive male crocodile in the Zoological Park of Antalya (Turkey was found dead without showing signs of any disease. Gross examination showed brown or red-spotted skin lesions of varying size. These lesions were mostly scattered over the abdomen and occasionally on the tail and feet. At necropsy, numerous white, multifocal and randomly distributed areas were seen on the liver. Gram-stained smears from skin and liver lesions showed Gram-negative bacilli arranged in clusters. Pure cultures of A. hydrophila were recovered from skin, internal organs and blood. Isolates were found to be susceptible to ceftiofur, amoxicillin + clavulanic acid, oxytetracycline, enrofloxacin, danofloxacin, neomycin, gentamicin, and lincomycin + neomycin. A pathogenicity test was performed using this isolate on 4 male 2-year-old New Zealand white rabbits. Local abscesses formed in 2 rabbits injected subcutaneously and the 2 that were injected intraperitoneally died as a result of septicaemia. In conclusion, this report has shown that A. hydrophila may cause skin lesions and even death due to septicaemia in crocodiles.

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

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Simone Vidal Santos

2014-12-01

Full Text Available Objective To understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method Qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results The following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion There is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.

Simulators of Squamous Cell Carcinoma of the Skin: Diagnostic Challenges on Small Biopsies and Clinico pathological Correlation

International Nuclear Information System (INIS)

Tan, K. B.; Tan, S. H.; Lee, Y. S.; Wee Aw, D. C.; Jaffar, H.; Lim, T. C.; Lee, S. J.

2013-01-01

Squamous cell carcinoma (SCC) is a common and important primary cutaneous malignancy. On skin biopsies, SCC is characterized by significant squamous cell atypia, abnormal keratinisation, and invasive features. Diagnostic challenges may occasionally arise, especially in the setting of small punch biopsies or superficial shave biopsies, where only part of the lesion may be assessable by the pathologist. Benign mimics of SCC include pseudoepitheliomatous hyperplasia, eccrine squamous syringometaplasia, inverted follicular keratosis, and keratoacanthoma, while malignant mimics of SCC include basal cell carcinoma, melanoma, and metastatic carcinoma. The careful application of time-honored diagnostic criteria, close clinico pathological correlation and a selective request for a further, deeper, or wider biopsy remain the most useful strategies to clinch the correct diagnosis. This review aims to present the key differential diagnoses of SCC, to discuss common diagnostic pitfalls, and to recommend ways to deal with diagnostically challenging cases

Reconstructing in-vivo reflectance spectrum of pigmented skin lesion by Monte Carlo simulation

Science.gov (United States)

Wang, Shuang; He, Qingli; Zhao, Jianhua; Lui, Harvey; Zeng, Haishan

2012-03-01

In dermatology applications, diffuse reflectance spectroscopy has been extensively investigated as a promising tool for the noninvasive method to distinguish melanoma from benign pigmented skin lesion (nevus), which is concentrated with the skin chromophores like melanin and hemoglobin. We carried out a theoretical study to examine melanin distribution in human skin tissue and establish a practical optical model for further pigmented skin investigation. The theoretical simulation was using junctional nevus as an example. A multiple layer skin optical model was developed on established anatomy structures of skin, the published optical parameters of different skin layers, blood and melanin. Monte Carlo simulation was used to model the interaction between excitation light and skin tissue and rebuild the diffuse reflectance process from skin tissue. A testified methodology was adopted to determine melanin contents in human skin based on in vivo diffuse reflectance spectra. The rebuild diffuse reflectance spectra were investigated by adding melanin into different layers of the theoretical model. One of in vivo reflectance spectra from Junctional nevi and their surrounding normal skin was studied by compare the ratio between nevus and normal skin tissue in both the experimental and simulated diffuse reflectance spectra. The simulation result showed a good agreement with our clinical measurements, which indicated that our research method, including the spectral ratio method, skin optical model and modifying the melanin content in the model, could be applied in further theoretical simulation of pigmented skin lesions.

Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence.

Science.gov (United States)

Jaworek-Korjakowska, Joanna; Kłeczek, Paweł

2016-01-01

Given its propensity to metastasize, and lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Different computer-aided diagnosis (CAD) systems have been proposed to increase the specificity and sensitivity of melanoma detection. Although such computer programs are developed for different diagnostic algorithms, to the best of our knowledge, a system to classify different melanocytic lesions has not been proposed yet. In this research we present a new approach to the classification of melanocytic lesions. This work is focused not only on categorization of skin lesions as benign or malignant but also on specifying the exact type of a skin lesion including melanoma, Clark nevus, Spitz/Reed nevus, and blue nevus. The proposed automatic algorithm contains the following steps: image enhancement, lesion segmentation, feature extraction, and selection as well as classification. The algorithm has been tested on 300 dermoscopic images and achieved accuracy of 92% indicating that the proposed approach classified most of the melanocytic lesions correctly. A proposed system can not only help to precisely diagnose the type of the skin mole but also decrease the amount of biopsies and reduce the morbidity related to skin lesion excision.

Initial evaluation of an ultrasound measure for assessing the activity of skin lesions in juvenile localized scleroderma.

Science.gov (United States)

Li, S C; Liebling, M S; Haines, K A; Weiss, J E; Prann, A

2011-05-01

To evaluate the construct validity of 2 proposed measures (the Ultrasound Disease Activity [U-DA] and the Tissue Thickness Score [TTS]) for evaluating sonographic differences in juvenile localized scleroderma skin lesions. We conducted a retrospective review of juvenile localized scleroderma patients who had ultrasound scans of their skin lesions between October 2005 and February 2009. Imaged lesions were classified as active or inactive based upon clinical assessment. Lesions had to have been imaged within 1 month of a clinic visit or have the same clinical assessment during both the visit before and the visit after the scan. Two physicians scored the scans using the U-DA, which scores for differences in lesion echogenicity and vascularity compared with normal tissue. Tissue thickness differences were evaluated by percent differences and by using the TTS. Wilcoxon's rank sum test was performed to assess differences. We studied 52 scans from 21 patients, 32 scans of active skin lesions and 20 scans of inactive skin lesions. Features reported by clinicians as indicative of active disease included erythema, warmth, violaceous color, new lesion, expansion of lesion, and induration. The U-DA was significantly different between active and inactive skin lesions (P = 0.0010) with significant differences found for the parameters of total echogenicity, hypodermis echogenicity, and deep tissue layer vascularity (P = 0.0014, P = 0.0023, and P = 0.0374, respectively). No significant differences were found for tissue layer thickness or TTS. The U-DA may be a useful tool in the identification of localized scleroderma activity. Further study is needed to prospectively evaluate the validity, reliability, and sensitivity of this potential monitoring tool. Copyright © 2011 by the American College of Rheumatology.

[Study of relationship between arsenic methylation and skin lesion in a population with long-term high arsenic exposure].

Science.gov (United States)

Su, Liqin; Cheng, Yibin; Lin, Shaobin; Wu, Chuanye

2007-05-01

To investigate the difference of arsenic metabolism in populations with long-term high arsenic exposure and explore the relationship between arsenic metabolism diversity and skin lesion. 327 residents in an arsenic polluted village were voluntarily enrolled in this study. Questionnaire survey and medical examination were carried out to learn basic information and detect skin lesions. Urinary inorganic and methylated arsenic were speciated by high performance liquid chromatography combined with hydride-generation atomic fluorescence spectrometry. Total arsenic concentration in hair was determined with DDC-Ag method. Hair arsenic content of studied polutions was generally high, but no significant difference were found among the studied four groups. MMA and DMA concentration in urine increased with studied polution age, and were positively related with skin lesion grade. The relative proportion of MMA in serious skin lesion group was significantly higher than in other 3 groups, while DMA/MMA ratio was significantly lower than control and mild group. The relative proportion of MMA was positively related with skin lesion grade, DMA/ MMA ratio was negatively related with skin lesion grade. Males could have higher arsenic cumulation and lower methylation capacity than those of females. The population of above 40 years old may have higher methylation capacity than those of adults below 40yeas old. Smokers and drinkers seemed lower methylation capacity than those of non-smokers and non-drinkers respectively. The methylation of arsenic could affect by several factors, including age gender, smoking and drinking. Arsenic methylation copacity mey be associated with skin lesion induced by arsenic exposure.

BLINCK?A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings

OpenAIRE

Bourne, Peter; Rosendahl, Cliff; Keir, Jeff; Cameron, Alan

2012-01-01

Background: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. Objectives: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primar...

Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

NARCIS (Netherlands)

van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A.

2014-01-01

Abstract Background: Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot

Reflectance spectroscopy of pigmented cutaneous benign and malignant lesions

Science.gov (United States)

Borisova, E.; Jeliazkova, Al.; Pavlova, E.; Troyanova, P.; Kundurdjiev, T.; Pavlova, P.; Avramov, L.

2014-10-01

For the DRS measurements of skin benign, dysplastic and malignant lesions in vivo we applied halogen lamp (LS-1, OceanOptics Inc, Dunedin, Fl, USA) as a continuous light source in the region of 400-900 nm, optical probe (6+1 fibers) for the delivery of illumination and diffuse reflected light from the skin investigated and microspectrometer USB4000 (OceanOptics Inc., Dunedin, Fl, USA) for a storage and display of the spectra detected. As a diffuse reflectance standard Spectralon® plate was used to calibrate the spectrometer. The reflectance spectra obtained from normal skin in identical anatomic sites of different patients have similar spectral shape features, slightly differ by the reflectance intensity at different wavelengths, depending on the particular patient' skin phototype. One could find diagnostically important spectral features, related to specific intensity changes for a given wavelength due to specific pigments appearance, slope changes by value and sign for the reflectance spectra curves in a specific spectral range, disappearance or manifestation of minima, related to hemoglobin absorption at 410-420 nm, 543, 575 nm. Based on the observed peculiarities multispectral analysis of the reflectance spectra of the different lesions was used and diagnostically specific features are found. Discrimination using the DRS data obtained between benign compound and dermal nevi (45 cases), dysplastic nevi (17 cases) and pigmented malignant melanoma (41 cases) lesions is achieved with a diagnostic accuracy of 96 % for the benign nevi vs. MM, and 90 % for the dysplastic nevi vs. MM.

Assessment of Optical Coherence Tomography Imaging in the Diagnosis of Non-Melanoma Skin Cancer and Benign Lesions Versus Normal Skin:

DEFF Research Database (Denmark)

Mogensen, Mette; Jørgensen, Thomas Martini; Nürnberg, Birgit Meincke

2009-01-01

BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess the diagn......BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess...

Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

NARCIS (Netherlands)

van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, C.; van der Heijden, Ferdinand; Bus, Sicco A.

2014-01-01

Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot complications such as

Early burn wound excision and skin grafting postburn trauma restores in vivo neutrophil delivery to inflammatory lesions

International Nuclear Information System (INIS)

Tchervenkov, J.I.; Epstein, M.D.; Silberstein, E.B.; Alexander, J.W.

1988-01-01

This study assessed the effect of early vs delayed postburn wound excision and skin grafting on the in vivo neutrophil delivery to a delayed-type hypersensitivity (DTH) reaction and a bacterial skin lesion (BSL). Male Lewis rats were presensitized to keyhole-limpet hemocyanin. Group 1 comprised sham controls. Groups 2 through 4 were given a 30% 3 degrees scald burn, but the burn wounds were excised, and skin was grafted on days 1, 3, and 7, respectively, after the burn. Group 5 comprised burn controls. Twelve days after burn trauma, all rats were injected at different intervals (during a 24-hour period) with a trio of intradermal injections of keyhole-limpet hemocyanin, Staphylococcus aureus 502A, and saline at different sites. In vivo neutrophil delivery to these dermal lesions was determined by injecting indium in 111 oxyquinoline-labeled neutrophils isolated from similarly treated groups of rats. Neutrophil delivery to DTH and BSL lesions was restored to normal by excision and skin grafting of the burn wound one day after burn trauma. Waiting three days after burn trauma to excise and skin graft the wound partially, but not completely, restored the in vivo neutrophil delivery to DTH and BSL lesions. Waiting one week to excise and skin graft a burn wound resulted in no improvement in neutrophil delivery to DTH and BSL dermal lesions. It was concluded that burn wound excision and skin grafting immediately after burn trauma restored in vivo neutrophil delivery to a BSL and DTH dermal lesion. This may, in part, explain the beneficial effect of early aggressive burn wound debridement in patients with burn injuries

Skin lesions simulating blue toe syndrome caused by prolonged contact with a millipede

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Augusto Scardazan Heeren Neto

2014-04-01

Full Text Available Venomous animals are those that, by means of a hunting and defense mechanism, are able to inject their prey with a toxic substance produced in their bodies, directly from specialized glands (e.g., tooth, sting, spur through which the poison passes. Millipedes are poisonous animals; they can be harmful to humans, and their effects usually manifest as erythematous, purpuric, and cyanotic lesions; local pain; and paresthesia. Here, we report a case of skin contact with a millipede for 6h resulting in skin lesions similar to blue toe syndrome.

[Skin and chronic kidney disease].

Science.gov (United States)

Rizzo, Raffaella; Mancini, Elena; Santoro, Antonio

2014-01-01

Kidneys and skin are seldom considered associated, but their relationship is more closer than generally believed. In some immunological diseases (SLE...) and genetic syndromes (tuberous sclerosis, Fabrys disease...) the cutaneous manifestations are integral parts of the clinical picture. In advanced uremia, besides the well-known itching skin lesions, calciphylaxis may appear, a typical example of cutaneous involvement secondary to the metabolic complications (calcium-phosphate imbalance) of the renal disease. Nephrogenic systemic fibrosis appears only in patients with renal failure and it has a very severe prognosis due to the systemic organ involvement. Moreover, there is a heterogeneous group of metabolic diseases, with renal involvement, that may be accompanied by skin lesions, either related to the disease itself or to its complications (diabetes mellitus, porphyrias). In systemic amyloidosis, fibrils may deposit even in dermis leading to different skin lesions. In some heroin abusers, in the presence of suppurative lesions in the sites of needle insertion, renal amyloidosis should be suspected, secondary to the chronic inflammation. Atheroembolic disease is nowadays frequently observed, as a consequence of the increasing number of invasive intravascular manoeuvres. Skin manifestations like livedo reticularis or the blue toe syndrome are the most typical signs, but often renal dysfunction is also present. In all these conditions, the skin lesion may be a first sign, a warning, that should arouse the suspicion of a more complex pathology, even with renal involvement. Being aware of this relationship is fundamental to accelerate the diagnostic process.

The effect of association between inefficient arsenic methylation capacity and demographic characteristics on the risk of skin lesions.

Science.gov (United States)

Rasheed, Hifza; Kay, Paul; Slack, Rebecca; Gong, Yun Yun

2018-01-15

This study was conducted in rural Pakistan to assess the dose-response relationship between skin lesions and arsenic exposure and their variation by demographic characteristics. The study included 398 participants (66 participants with skin lesions and 332 without) residing in six previously unstudied villages exposed to ground water arsenic in the range of iAs), total arsenic (tAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were analysed to determine methylation capacity, methylation efficiency and the dose-response relationship with skin lesions. Study participants with skin lesions were found to be exposed to arsenic >10μgL -1 with a daily arsenic intake of 3.23±3.75mgday -1 from household ground water sources for an exposure duration of 10-20years. The participants with skin lesions compared to those without skin lesions showed higher levels of urinary iAs (133.40±242.48 vs. 44.24±86.48μgg -1 Cr), MMA (106.38±135.04 vs. 35.43±39.97μgg -1 Cr), MMA% (15.26±6.31 vs.12.11±4.68) and lower levels of DMA% (66.99±13.59 vs. 73.39±10.44) and secondary methylation index (SMI) (0.81±0.11 vs. 0.86±0.07). Study participants carrying a lower methylation capacity characterized by higher MMA% (OR 5.06, 95% CI: 2.09-12.27), lower DMA% (OR 0.64, 95% CI: 0.33-1.26), primary methylation index (PMI) (OR 0.56, 95% CI: 0.28-1.12) and SMI (OR 0.43, 95% CI: 0.21-0.88) had a significantly higher risk of skin lesions compared to their corresponding references after adjusting for occupation categories. The findings confirmed that inefficient arsenic methylation capacity was significantly associated with increased skin lesion risks and the effect might be modified by labour intensive occupations. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Effect of Acer tegmentosum bark on atopic dermatitis-like skin lesions in NC/Nga mice.

Science.gov (United States)

Yang, Gabsik; An, Duckgun; Lee, Mi-Hwa; Lee, Kyungjin; Kim, Bumjung; Suman, Chinannai Khanita; Ham, Inhye; Choi, Ho-Young

2016-01-11

Atopic dermatitis (AD) is a chronic and relapsing inflammatory condition characterized by pruritic and eczematous skin lesions that requires safe and effective pharmacological therapy. The bark of Acer tegmentosum Maxim trees has been used in Korean folk and traditional medicine to treat abscesses, surgical bleeding, liver diseases, and AD. To investigate the therapeutic effect of A. tegmentosum, on a mouse model of Dermatophagoides farinae (Df)-induced AD. Development of AD-like skin lesions was induced by repetitive skin contact with barrier-disrupted backs of NC/Nga mice with Df body ointment, and the effects of A. tegmentosum were evaluated on the basis of histopathological skin assessment results, ear swelling, and cytokine production in the dorsal skin. The component of A. tegmentosum, salidroside, inhibited the production of TSLP in KCMH-1 cells, which indicated that its production could be pharmacologically regulated. Topical application of A. tegmentosum for 1 week after Df body ointment challenge significantly reduced ear swelling and improved dorsal skin lesions. Suppression of dermatitis by combined therapy was accompanied by a decrease in the skin level of Th2 cytokines, such as interleukin (IL)-4, IL-5 and IL-13, plasma levels of thymus and activation-regulated chemokine, and IgE. Induction of thymic stromal lymphopoietin, which leads to a systemic Th2 response, was also reduced in in vivo and in vitro by A. tegmentosum and salidroside. Our findings suggest that A. tegmentosum treatment has a significant therapeutic effect on Df-induced AD-like skin lesions on NC/Nga mice through inhibition of thymic stromal lymphopoietin and IgE via a mechanism that may inhibit Th2-mediated immune responses. These results suggest that A. tegmentosum and salidroside may be useful tools for the treatment of AD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Visualization of dermal alteration in skin lesions with discoid lupus erythematosus by multiphoton microscopy

International Nuclear Information System (INIS)

Lin, L H; Yu, H B; Zhu, X Q; Zhuo, S M; Chen, J X; Wang, Y Y; Yang, Y H

2013-01-01

Discoid lupus erythematosus (DLE) is a chronic dermatological disease which lacks valid methods for early diagnosis and therapeutic monitoring. Considering the collagen and elastin disorder due to mucin deposition of DLE, multiphoton microscopy (MPM) imaging techniques were employed to obtain high-resolution collagen and elastin images from the dermis. The content and distribution of collagen and elastin were quantified to characterize the dermal pathological status of skin lesions with DLE in comparison with normal skin. Our results showed a significant difference between skin lesions with DLE and normal skin in terms of the morphological structure of collagen and elastin in the dermis, demonstrating the possibility of MPM for noninvasively tracking the pathological process of DLE even in its early stages and evaluating the therapeutic efficacy at the molecular level. (paper)

Ranavirus infections associated with skin lesions in lizards.

Science.gov (United States)

Stöhr, Anke C; Blahak, Silvia; Heckers, Kim O; Wiechert, Jutta; Behncke, Helge; Mathes, Karina; Günther, Pascale; Zwart, Peer; Ball, Inna; Rüschoff, Birgit; Marschang, Rachel E

2013-09-27

Ranaviral disease in amphibians has been studied intensely during the last decade, as associated mass-mortality events are considered to be a global threat to wild animal populations. Several studies have also included other susceptible ectothermic vertebrates (fish and reptiles), but only very few cases of ranavirus infections in lizards have been previously detected. In this study, we focused on clinically suspicious lizards and tested these animals for the presence of ranaviruses. Virological screening of samples from lizards with increased mortality and skin lesions over a course of four years led to the detection of ranaviral infections in seven different groups. Affected species were: brown anoles (Anolis sagrei), Asian glass lizards (Dopasia gracilis), green anoles (Anolis carolinensis), green iguanas (Iguana iguana), and a central bearded dragon (Pogona vitticeps). Purulent to ulcerative-necrotizing dermatitis and hyperkeratosis were diagnosed in pathological examinations. All animals tested positive for the presence of ranavirus by PCR and a part of the major capsid protein (MCP) gene of each virus was sequenced. Three different ranaviruses were isolated in cell culture. The analyzed portions of the MCP gene from each of the five different viruses detected were distinct from one another and were 98.4-100% identical to the corresponding portion of the frog virus 3 (FV3) genome. This is the first description of ranavirus infections in these five lizard species. The similarity in the pathological lesions observed in these different cases indicates that ranaviral infection may be an important differential diagnosis for skin lesions in lizards.

Skin lesions caused by orthopoxvirus infection in a dog.

Science.gov (United States)

Smith, K C; Bennett, M; Garrett, D C

1999-10-01

A seven-year-old male dobermann was presented for examination of a non-pruritic ulcerated lesion occurring at the site of a suspected rat bite on the muzzle. Biopsy revealed focal ulcerative dermatitis, with cells in the epidermis, follicular infundibula and interposed sebaceous glands undergoing ballooning degeneration and containing large acidophilic intracytoplasmic structures resembling poxvirus inclusion bodies. The diagnosis of orthopoxvirus infection was confirmed by transmission electron microscopy and immunohistochemistry. The biopsy site healed uneventfully, without evidence of recurrence or development of further cutaneous or internal lesions, and a serum sample collected eight weeks after first presentation had a low titre of poxvirus antibodies. This report demonstrates that orthopoxvirus infection should be considered as a cause of ulcerative skin lesions in dogs, particularly if there has been recent contact with rodents or other small mammals.

Imaging Blood Vessel Morphology in Skin

DEFF Research Database (Denmark)

Schuh, Sandra; Holmes, Jon; Ulrich, Martina

2017-01-01

Conventional optical coherence tomography (OCT) enables the visualization of morphological changes of skin cancer. The use of OCT in the diagnostic investigation and in the therapy decision of non-melanoma skin cancer and other skin changes is already established, and has found its way into routine...... practice. With the development of speckle-variance OCT, also named dynamic OCT (D-OCT), the vascular architecture and the blood flow of the skin can be displayed in vivo and in 3D. This novel angiographic variant of OCT offers the ability to visualize and measure vessel morphology providing a new insight...... into healthy, inflammatory and neoplastic skin lesions such as malignant melanoma. This review focuses on the possibilities of using D-OCT on healthy and diseased skin. We suggest and illustrate key diagnostic characteristics by analyzing the initial publications and preliminary unpublished data on vessel...

In Situ complement activation and T-cell immunity in leprosy spectrum: An immunohistological study on leprosy lesional skin.

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Nawal Bahia El Idrissi

Full Text Available Mycobacterium leprae (M. leprae infection causes nerve damage and the condition worsens often during and long after treatment. Clearance of bacterial antigens including lipoarabinomannan (LAM during and after treatment in leprosy patients is slow. We previously demonstrated that M. leprae LAM damages peripheral nerves by in situ generation of the membrane attack complex (MAC. Investigating the role of complement activation in skin lesions of leprosy patients might provide insight into the dynamics of in situ immune reactivity and the destructive pathology of M. leprae. In this study, we analyzed in skin lesions of leprosy patients, whether M. leprae antigen LAM deposition correlates with the deposition of complement activation products MAC and C3d on nerves and cells in the surrounding tissue. Skin biopsies of paucibacillary (n = 7, multibacillary leprosy patients (n = 7, and patients with erythema nodosum leprosum (ENL (n = 6 or reversal reaction (RR (n = 4 and controls (n = 5 were analyzed. The percentage of C3d, MAC and LAM deposition was significantly higher in the skin biopsies of multibacillary compared to paucibacillary patients (p = <0.05, p = <0.001 and p = <0.001 respectively, with a significant association between LAM and C3d or MAC in the skin biopsies of leprosy patients (r = 0.9578, p< 0.0001 and r = 0.8585, p<0.0001 respectively. In skin lesions of multibacillary patients, MAC deposition was found on axons and co-localizing with LAM. In skin lesions of paucibacillary patients, we found C3d positive T-cells in and surrounding granulomas, but hardly any MAC deposition. In addition, MAC immunoreactivity was increased in both ENL and RR skin lesions compared to non-reactional leprosy patients (p = <0.01 and p = <0.01 respectively. The present findings demonstrate that complement is deposited in skin lesions of leprosy patients, suggesting that inflammation driven by complement activation might contribute to nerve damage in the lesions

The diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions

International Nuclear Information System (INIS)

Wang Hui; Zhang Fuchen; Ji Hongjian; Chen Liping

2009-01-01

Objective: To evaluate the diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions. Methods: The clinical data of CT-guided transthoracic cutting needle biopsy in 436 patients performed in past 10 years were retrospectively analyzed. Of 436 cases with pulmonary lesions, primary lung cancer was confirmed in 341, pulmonary metastasis in 62, non-malignant lesions in 33. The diagnostic accuracy and sensitivity were statistically analyzed. The occurrence of complications was discussed. Results: The diagnostic accuracy rate and sensitivity rate in primary lung cancer group were 94.7% and 94.1% respectively, in pulmonary metastasis group were 58.2% and 51.6% respectively and in non-malignant lesions group were 57.6% and 57.6% respectively. The successful rate of biopsy was 97.9%. The occurrence of complications was 15.6%. Conclusion: CT-guided percutaneous transthoracic cutting needle biopsy is a safe and valuable diagnostic technique with high diagnostic accuracy and less complications. It is very helpful in confirming the diagnosis in the patients with suspected primary pulmonary cancer, although the technical procedures need to be further improved for metastatic and non-malignant lung lesions. (authors)

Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence

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Joanna Jaworek-Korjakowska

2016-01-01

Full Text Available Background. Given its propensity to metastasize, and lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Different computer-aided diagnosis (CAD systems have been proposed to increase the specificity and sensitivity of melanoma detection. Although such computer programs are developed for different diagnostic algorithms, to the best of our knowledge, a system to classify different melanocytic lesions has not been proposed yet. Method. In this research we present a new approach to the classification of melanocytic lesions. This work is focused not only on categorization of skin lesions as benign or malignant but also on specifying the exact type of a skin lesion including melanoma, Clark nevus, Spitz/Reed nevus, and blue nevus. The proposed automatic algorithm contains the following steps: image enhancement, lesion segmentation, feature extraction, and selection as well as classification. Results. The algorithm has been tested on 300 dermoscopic images and achieved accuracy of 92% indicating that the proposed approach classified most of the melanocytic lesions correctly. Conclusions. A proposed system can not only help to precisely diagnose the type of the skin mole but also decrease the amount of biopsies and reduce the morbidity related to skin lesion excision.

Roentgenologic diagnostics of capsular ligament lesions

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Wirth, C.J.; Jaeger, M.

1981-10-01

The X-ray diagnostic is of obvious importance and relevance in the detection of acute or old capsular ligament lesions of the limb joint. On the one hand it serves as the plain radiograph (roentgenogram without contrast medium) for the assessment of osseous secondary lesions, for the documentation of luxationary positions of the joint partners, and in old capsular ligament lesions for the detection of an already existing arthrosis. On the other hand the X-ray images are of main importance, which are made from the hand-held limb in order to permit a comparison of the two sides, and which beyond the clinical detection of a joint instability indicate the extent and the direction of this instability and which also document it, and which allow in adolescents to recognize a separation of the epiphysis as an alternative to the capsular ligament rupture. Only in particular cases arthrography can provide some additional information, so for example in the case of an isolated syndesmosis rupture, ruptures of the rosette of the rotator muscle or of a damaged triangular disk in the hand. Angiography is only required in cases of traumatic luxations of the knee in order to exclude an intimal lesion of the popliteal artery.

Detection of human papillomavirus in nonmelanoma skin cancer lesions and healthy perilesional skin in kidney transplant recipients and immunocompetent patients.

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Bernat-García, J; Morales Suárez-Varela, M; Vilata-Corell, J J; Marquina-Vila, A

2014-04-01

The influence of human papillomavirus (HPV) on the development of nonmelanoma skin cancer (NMSC) is a topic of debate. HPV types from the beta genus (HPV-β) have been most frequently associated with the development of skin cancer. To analyze the prevalence and range of HPV types in NMSC lesions and healthy perilesional skin in immunodepressed and immunocompetent patients and to evaluate the influence of various clinical factors on the prevalence of HPV in skin cancer. Nested polymerase chain reaction and sequencing were used to detect HPV in 120 NMSC samples obtained by biopsy from 30 kidney transplant recipients and 30 immunocompetent patients. In all cases, a sample was taken from the tumor site and the surrounding healthy skin. Potential confounders were assessed and the data analyzed by multivariate logistic regression. HPV DNA was detected in 44 (73.3%) of the 60 samples from immunodepressed patients and in 32 (53.3%) of the 60 samples from immunocompetent patients (adjusted odds ratio, 3.4; 95% CI, 1.2-9.6). In both groups of patients, HPV was more common in healthy perilesional skin than in lesional skin. HPV-β was the most common type isolated. We found a wide range of HPV types (mostly HPV-β) in the skin of kidney transplant recipients and immunocompetent patients with skin cancer. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

Immunolocalization of lactoferrin in surgically resected pigmented skin lesions

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G Tuccari

2009-06-01

Full Text Available Lactoferrin (Lf expression was determined immunohistochemically in 57 formalin-fixed paraffin-embedded bioptic samples obtained from an equal number of patients treated by surgery to remove pigmented skin lesions (nevi = 23; melanoma = 12; vulgaris and seborrhoeic warts = 12; basal cell carcinoma = 10; in addition, 10 specimens of normal skin were studied as control. On 3 ?m thick sections, depigmentation and antigen retrieval procedures were performed. The Lf immunoreactivity was revealed by a rabbit anti-human Lf. Quantification of Lf immunoreactivity was performed using an intensity-distribution (ID score. Melanocytic cells, regardless of their benign or malignant nature, were consistently stained, with no significant differences in the Lf IDscore between melanomas or nevi. A different intensity of Lf immunoreactivity was encountered in superficial portions of warts, exclusively inside squamous epithelial cells arranged in sheets or whorls of keratin. On the contrary, basal cell carcinomas were always unstained, while a slight Lf positivity was found in focal keratinized areas present in two tumours showing baso-squamous differentiation. The Lf immunoreactivity was localized in the cytoplasm and only occasionally in the nucleus. The biological meaning of Lf in these cases of human skin specimens remains unexplained, although it cannot be ruled out that Lf might be involved in the defense system against tumours, or alternatively, may be used by cells requiring iron availability for their turnover. Moreover, the immunohistochemical expression of Lf in melanocytic lesions might be also related to a Lf-melanin interaction. Finally, the involvement of Lf in skin squamous non-neoplastic elements could be related to its role as one of the molecules modulating an unspecific inflammatory or anti-oxidant response.

Topical efficacy of dimercapto-chelating agents against lewisite-induced skin lesions in SKH-1 hairless mice

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Mouret, Stéphane, E-mail: stephane.mouret@irba.fr [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Wartelle, Julien; Emorine, Sandy; Bertoni, Marine; Nguon, Nina; Cléry-Barraud, Cécile [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Dorandeu, Frédéric [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Ecole du Val-de-Grâce, 1 place Alphonse Laveran, Paris (France); Boudry, Isabelle [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France)

2013-10-15

Lewisite is a potent chemical warfare arsenical vesicant that can cause severe skin lesions. Today, lewisite exposure remains possible during demilitarization of old ammunitions and as a result of deliberate use. Although its cutaneous toxicity is not fully elucidated, a specific antidote exists, the British anti-lewisite (BAL, dimercaprol) but it is not without untoward effects. Analogs of BAL, less toxic, have been developed such as meso-2,3-dimercaptosuccinic acid (DMSA) and have been employed for the treatment of heavy metal poisoning. However, efficacy of DMSA against lewisite-induced skin lesions remains to be determined in comparison with BAL. We have thus evaluated in this study the therapeutic efficacy of BAL and DMSA in two administration modes against skin lesions induced by lewisite vapor on SKH-1 hairless mice. Our data demonstrate a strong protective efficacy of topical application of dimercapto-chelating agents in contrast to a subcutaneous administration 1 h after lewisite exposure, with attenuation of wound size, necrosis and impairment of skin barrier function. The histological evaluation also confirms the efficacy of topical application by showing that treatments were effective in reversing lewisite-induced neutrophil infiltration. This protective effect was associated with an epidermal hyperplasia. However, for all the parameters studied, BAL was more effective than DMSA in reducing lewisite-induced skin injury. Together, these findings support the use of a topical form of dimercaprol-chelating agent against lewisite-induced skin lesion within the first hour after exposure to increase the therapeutic management and that BAL, despite its side-effects, should not be abandoned. - Highlights: • Topically applied dimercapto-chelating agents reduce lewisite-induced skin damage. • One topical application of BAL or DMSA is sufficient to reverse lewisite effects. • Topical BAL is more effective than DMSA to counteract lewisite-induced skin damage.

KIT D816V mutation-positive cell fractions in lesional skin biopsies from adults with systemic mastocytosis

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Kielsgaard Kristensen, Thomas; Broesby-Olsen, Sigurd; Vestergaard, Hanne

2013-01-01

Most adults with systemic mastocytosis (SM) carry the somatic KIT D816V mutation, but the occurrence of the mutation in lesional skin remains to be characterized.......Most adults with systemic mastocytosis (SM) carry the somatic KIT D816V mutation, but the occurrence of the mutation in lesional skin remains to be characterized....

Multiple Erythema Lesions Obscured As Fungal Skin Infection

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Koçinaj, Allma; Gërçari, Antigona; Ferizi, Mybera; Lashi, Edlira; Gjunkshi, Lorela; Fida, Monika

2014-01-01

Erythema migrans is a ring like erythema, with a few centimeters in diameter. Usually it occur solitary, days to weeks after an infected tick bite. According to skin changes it can be manifested acutely such as erythema migrans in Lyme Borreliosis, borrelial lymphocytoma (subacute), or as a late Lyme disease with acrodermatitis chronica atrophicans. All stages of this disease can be treatable with antimicrobial agents. As a first case in our department with multiple lesions, we describe a 14-...

Clay jojoba oil facial mask for lesioned skin and mild acne--results of a prospective, observational pilot study.

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Meier, Larissa; Stange, Rainer; Michalsen, Andreas; Uehleke, Bernhard

2012-01-01

External application of clay facial masks is a cosmetic procedure generally used to reduce skin lesions and to improve overall skin condition. Collecting pilot data about self-treatment with clay jojoba oil masks on participants with acne-prone, lesioned skin and acne. Open, prospective, observational pilot study: Participants received written information, instructions, and questionnaires without direct contact with the study physician. For 6 weeks, they applied the masks 2-3 times per week. The primary outcome is the difference of skin lesions: baseline vs. after 6 weeks. 194 participants (192 female, 2 male, mean age (± SE) (32.3 ± 0.7 years) returned questionnaires and diaries. 133 of these participants returned complete and precise lesion counts (per-protocol (PP) collective). A 54% mean reduction in total lesion count was observed after 6 weeks of treatment with clay facial mask. Both inflammatory and non-inflammatory skin lesions were reduced significantly after treatment compared to baseline: Median counts (MC) of pustules per affected participant were reduced from 7.0 ± 0.9 to 3.0 ± 0.5 (mean individual reduction (MIR) = 49.4%), the MC of the papules from 3.5 ± 2.2 to 1.0 ± 0.4 (MIR = 57.3%), the MC of cysts from 2.0 ± 0.8 to 0.5 ± 0.4 (MIR = 68.6%) and the MC of comedones from 26.5 ± 6.3 to 16.0 ± 4.0 (MIR = 39.1%). DLQI-average score decreased from 5.0 ± 4.5 (mean ± SE) before to 2.1 ± 2.8 after treatment. The present study gives preliminary evidence that healing clay jojoba oil facial masks can be effective treatment for lesioned skin and mild acne vulgaris. Copyright © 2012 S. Karger AG, Basel.

Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan

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Salman Hussein

2011-09-01

Full Text Available Abstract Background So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO. Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1. Cross tabulation and Chi-square with Fisher's exact test were used. Results A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p Tongue lesions were the most frequently diagnosed OML (23.3%, followed in descending order by white lesions (19.1%, red and blue lesions (11% and vesiculobullous diseases (6%. OML in various skin diseases were; vesiculobullous reaction pattern (72.2%, lichenoid reaction pattern (60.5%, infectious lesions (56.5%, psoriasiform reaction pattern (56.7%, and spongiotic reaction pattern (46.8%. Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p Conclusions OML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination

The detection of lumpy skin disease virus in samples of experimentally infected cattle using different diagnostic techniques

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E.S.M. Tuppurainen

2005-09-01

Full Text Available Lumpy skin disease (LSD is a disease of cattle, primarily in Africa and Madagascar and rarely in the Middle East. It is caused by a capripoxvirus that belongs to the family Poxviridae. The disease is of economic importance in endemic areas. Effective control of LSD requires accurate and rapid laboratory techniques to confirm a tentative clinical diagnosis. Comparative studies on different diagnostic tests used at different stages of the disease have not been done. The aim of this study was to compare several of these tests. Six seronegative bulls, between 11 and 20 months of age, were infected intravenously and kept in an insect-free facility. The course of the infection was monitored. During a 3-month period blood samples and skin biopsies were collected for virus isolation and polymerase chain reaction (PCR. Skin biopsies were also examined using transmission electron microscopy (TEM. The incubation period in infected animals varied from 4-5 days. The length of the viraemic period did not correlate with the severity of clinical disease. Viraemia was detected from 1-12 days using virus isolation and from 4-11 days using the PCR, which is longer than has previously been reported. Virus was isolated from skin biopsies until Day 39 post infection (p.i. and PCR could demonstrate viral DNA until Day 92 p.i. Transmission electron microscopy of negatively stained skin biopsies detected LSD virus only in one of the four bulls that developed skin lesions until Day 33 p.i. The PCR was a fast and sensitive method to demonstrate viral DNA in blood and skin samples. It could detect viral nucleic acid in skin lesions 53 days longer than virus isolation. Virus isolation from blood and skin samples was sensitive and reliable, but as a single test it may be too time-consuming to use although this depends on how rapidly the diagnosis must be confirmed. In conclusion, this study showed the PCR to be superior in detecting LSD virus from blood and skin samples

Mast cell heterogeneity and anti-inflammatory annexin A1 expression in leprosy skin lesions.

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Costa, Maurício B; Mimura, Kallyne K O; Freitas, Aline A; Hungria, Emerith M; Sousa, Ana Lúcia O M; Oliani, Sonia M; Stefani, Mariane M A

2018-03-29

Mast cells (MCs) have important immunoregulatory roles in skin inflammation. Annexin A1 (ANXA1) is an endogenous anti-inflammatory protein that can be expressed by mast cells, neutrophils, eosinophils, monocytes, epithelial and T cells. This study investigated MCs heterogeneity and ANXA1 expression in human dermatoses with special emphasis in leprosy. Sixty one skin biopsies from 2 groups were investigated: 40 newly diagnosed untreated leprosy patients (18 reaction-free, 11 type 1 reaction/T1R, 11 type 2 reaction/T2R); 21 patients with other dermatoses. Tryptase/try+ and chymase/chy + phenotypic markers and toluidine blue stained intact/degranulated MC counts/mm 2 were evaluated. Try + /chy + MCs and ANXA1 were identified by streptavidin-biotin-peroxidase immunostaining and density was reported. In leprosy, degranulated MCs outnumbered intact ones regardless of the leprosy form (from tuberculoid/TT to lepromatous/LL), leprosy reactions (reactional/reaction-free) and type of reaction (T1R/T2R). Compared to other dermatoses, leprosy skin lesions showed lower numbers of degranulated and intact MCs. Try + MCs outnumbered chy + in leprosy lesions (reaction-free/reactional, particularly in T2R), but not in other dermatoses. Compared to other dermatoses, ANXA1 expression, which is also expressed in mast cells, was higher in the epidermis of leprosy skin lesions, independently of reactional episode. In leprosy, higher MC degranulation and differential expression of try + /chy + subsets independent of leprosy type and reaction suggest that the Mycobacterium leprae infection itself dictates the inflammatory MCs activation in skin lesions. Higher expression of ANXA1 in leprosy suggests its potential anti-inflammatory role to maintain homeostasis preventing tissue and nerve damage. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multispectral detection of cutaneous lesions using spectroscopy and microscopy approaches

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Borisova, E.; Genova-Hristova, Ts.; Troyanova, P.; Pavlova, E.; Terziev, I.; Semyachkina-Glushkovskaya, O.; Lomova, M.; Genina, E.; Stanciu, G.; Tranca, D.; Avramov, L.

2018-02-01

Autofluorescence, diffuse-reflectance and transmission spectral, and microscopic measurements were made on different cutaneous neoplastic lesions, namely basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and dysplastic and benign lesions related. Spectroscopic measurements were made on ex vivo tissue samples, and confocal microscopy investigations were made on thin tissue slices. Fluorescence spectra obtained reveal statistically significant differences between the different benign, dysplastic and malignant lesions by the level of emission intensity, as well by spectral shape, which are fingerprints applicable for differentiation algorithms. In reflectance mode the most significant differences are related to the influence of skin pigments - melanin and hemoglobin. Transmission spectroscopy mode gave complementary optical properties information about the tissue samples investigated to that one of reflectance and absorption spectroscopy. Using autofluorescence detection of skin lesions we obtain very good diagnostic performance for distinguishing of nonmelanoma lesions. Using diffuse reflectance and transmission spectroscopy we obtain significant tool for pigmented pathologies differentiation, but it is a tool with moderate sensitivity for non-melanoma lesions detection. One could rapidly increase the diagnostic accuracy of the received combined "optical biopsy" method when several spectral detection techniques are applied in common algorithm for lesions' differentiation. Specific spectral features observed in each type of lesion investigated on micro and macro level would be presented and discussed. Correlation between the spectral data received and the microscopic features observed would be discussed in the report.

Differences of Urinary Arsenic Metabolites and Methylation Capacity between Individuals with and without Skin Lesions in Inner Mongolia, Northern China

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Qiang Zhang

2014-07-01

Full Text Available Incomplete arsenic (As methylation has been considered a risk factor of As-related diseases. This study aimed to examine the difference of urinary As metabolites and the methylation capacity between subjects with and without skin lesions. Urinary inorganic arsenic (iAs, monomethylarsonic acid (MMA, and dimethylarsinic acid (DMA were analyzed. The percentage of each As species (iAs%, MMA%, and DMA%, the primary methylation index (PMI and secondary methylation index (SMI were calculated. The results showed that subjects with skin lesions have higher levels of urinary iAs (99.08 vs. 70.63 μg/g Cr, p = 0.006 and MMA (69.34 vs. 42.85 μg/g Cr, p = 0.016 than subjects without skin lesions after adjustment for several confounders. Significant differences of urianry MMA% (15.49 vs. 12.11, p = 0.036 and SMI (0.74 vs. 0.81, p = 0.025 were found between the two groups. The findings of the present study suggest that subjects with skin lesions may have a lower As methylation capacity than subjects without skin lesions.

Differences of urinary arsenic metabolites and methylation capacity between individuals with and without skin lesions in Inner Mongolia, Northern China.

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Zhang, Qiang; Li, Yongfang; Liu, Juan; Wang, Da; Zheng, Quanmei; Sun, Guifan

2014-07-18

Incomplete arsenic (As) methylation has been considered a risk factor of As-related diseases. This study aimed to examine the difference of urinary As metabolites and the methylation capacity between subjects with and without skin lesions. Urinary inorganic arsenic (iAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were analyzed. The percentage of each As species (iAs%, MMA%, and DMA%), the primary methylation index (PMI) and secondary methylation index (SMI) were calculated. The results showed that subjects with skin lesions have higher levels of urinary iAs (99.08 vs. 70.63 μg/g Cr, p = 0.006) and MMA (69.34 vs. 42.85 μg/g Cr, p = 0.016) than subjects without skin lesions after adjustment for several confounders. Significant differences of urianry MMA% (15.49 vs. 12.11, p = 0.036) and SMI (0.74 vs. 0.81, p = 0.025) were found between the two groups. The findings of the present study suggest that subjects with skin lesions may have a lower As methylation capacity than subjects without skin lesions.

Novel Approaches for Diagnosing Melanoma Skin Lesions Through Supervised and Deep Learning Algorithms.

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Premaladha, J; Ravichandran, K S

2016-04-01

Dermoscopy is a technique used to capture the images of skin, and these images are useful to analyze the different types of skin diseases. Malignant melanoma is a kind of skin cancer whose severity even leads to death. Earlier detection of melanoma prevents death and the clinicians can treat the patients to increase the chances of survival. Only few machine learning algorithms are developed to detect the melanoma using its features. This paper proposes a Computer Aided Diagnosis (CAD) system which equips efficient algorithms to classify and predict the melanoma. Enhancement of the images are done using Contrast Limited Adaptive Histogram Equalization technique (CLAHE) and median filter. A new segmentation algorithm called Normalized Otsu's Segmentation (NOS) is implemented to segment the affected skin lesion from the normal skin, which overcomes the problem of variable illumination. Fifteen features are derived and extracted from the segmented images are fed into the proposed classification techniques like Deep Learning based Neural Networks and Hybrid Adaboost-Support Vector Machine (SVM) algorithms. The proposed system is tested and validated with nearly 992 images (malignant & benign lesions) and it provides a high classification accuracy of 93 %. The proposed CAD system can assist the dermatologists to confirm the decision of the diagnosis and to avoid excisional biopsies.

Skin lesion-associated pathogens from Octopus vulgaris: first detection of Photobacterium swingsii, Lactococcus garvieae and betanodavirus.

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Fichi, G; Cardeti, G; Perrucci, S; Vanni, A; Cersini, A; Lenzi, C; De Wolf, T; Fronte, B; Guarducci, M; Susini, F

2015-07-23

The common octopus Octopus vulgaris Cuvier, 1798 is extremely important in fisheries and is a useful protein source in most Mediterranean countries. Here we investigated pathogens associated with skin lesions in 9 naturally deceased specimens that included both cultured and wild common octopus. Within 30 min after death, each octopus was stored at 4°C and microbiologically examined within 24 h. Bacterial colonies, cultured from swabs taken from the lesions, were examined using taxonomical and biochemical analyses. Vibrio alginolyticus and V. parahaemolyticus were only isolated from cultured animals. A conventional PCR targeting the 16S ribosomal RNA (rRNA) gene and sequencing were performed on 2 bacterial isolates that remained unidentified after taxonomical and biochemical analysis. The sequence results indicated that the bacteria had a 99% identity with Lactococcus garvieae and Photobacterium swingsii. L. garvieae was confirmed using a specific PCR based on the 16S-23S rRNA internal transcribed spacer region, while P. swingsii was confirmed by phylogenetic analyses. Although all animals examined were found to be infected by the protozoan species Aggregata octopiana localised in the intestines, it was also present in skin lesions of 2 of the animals. Betanodavirus was detected in both cultured and wild individuals by cell culture, PCR and electron microscopy. These findings are the first report of L. garvieae and betanodavirus from skin lesions of common octopus and the first identification of P. swingsii both in octopus skin lesions and in marine invertebrates in Italy.

Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

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Zhuang, Yi-Ping, E-mail: yipingzhuang2010@sina.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Wang, Hai-Yan, E-mail: mycherishgirl@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Jin, E-mail: yari_zj@hotmail.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Feng, Yong, E-mail: fengyong119@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Lei, E-mail: motozl163@163.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China)

2013-01-15

Objective: CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions. Materials and methods: 102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness. Results: The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05). Conclusion: CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

Protective effects of B vitamins and antioxidants on the risk of arsenic-related skin lesions in Bangladesh.

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Zablotska, Lydia B; Chen, Yu; Graziano, Joseph H; Parvez, Faruque; van Geen, Alexander; Howe, Geoffrey R; Ahsan, Habibul

2008-08-01

An estimated 25-40 million of the 127 million people of Bangladesh have been exposed to high levels of naturally occurring arsenic from drinking groundwater. The mitigating effects of diet on arsenic-related premalignant skin lesions are largely unknown. The purpose of this study was to clarify the effects of the vitamin B group (thiamin, riboflavin, niacin, pyridoxine, and cobalamin) and antioxidants (vitamins A, C, and E) on arsenic-related skin lesions. We performed a cross-sectional study using baseline data from the Health Effects of Arsenic Longitudinal Study (HEALS), 2000-2002, with individual-level, time-weighted measures of arsenic exposure from drinking water. A total of 14,828 individuals meeting a set of eligibility criteria were identified among 65,876 users of all 5,996 tube wells in the 25-km(2) area of Araihazar, Bangladesh; 11,746 were recruited into the study. This analysis is based on 10,628 subjects (90.5%) with nonmissing dietary data. Skin lesions were identified according to a structured clinical protocol during screening and confirmed with further clinical review. Riboflavin, pyridoxine, folic acid, and vitamins A, C, and E significantly modified risk of arsenic-related skin lesions. The deleterious effect of ingested arsenic, at a given exposure level, was significantly reduced (ranging from 46% reduction for pyridoxine to 68% for vitamin C) for persons in the highest quintiles of vitamin intake. Intakes of B-vitamins and antioxidants, at doses greater than the current recommended daily amounts for the country, may reduce the risk of arsenic-related skin lesions in Bangladesh.

The effect of hydroxychloroquine on lupus erythematosus-like skin lesions in MRL/lpr mice.

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Shimomatsu, Tatsuya; Kanazawa, Nobuo; Mikita, Naoya; Nakatani, Yumi; Li, Hong-Jin; Inaba, Yutaka; Ikeda, Takaharu; Kondo, Toshikazu; Furukawa, Fukumi

2016-09-01

To evaluate the effect and safety of hydroxychloroquine (HCQ) on lupus erythematosus (LE)-like skin lesions in the MRL/lpr mouse, a model for systemic LE (SLE). We divided the MRL/lpr mice into three groups that were given: (1) drinking water, (2) HCQ at a dose of 4 mg/kg/d, or (3) HCQ at a dose of 40 mg/kg/d. The HCQ was administered to examine the effect and safety of HCQ on skin lesions and the number of infiltrating cells including mast cells in the dermis. Six of 13 mice in the group given drinking water, 3 of 11 mice in the group administered low-dose HCQ (4 mg/kg/d), and 1 of 10 mice in the group administered high-dose HCQ (40 mg/kg/d) presented the skin lesions. The average number of mast cells was 81, 50, and 12 (magnification, ×100), the mortality rate was 24%, 8%, and 9% and the mean body weight gain was 4.6 g, 8.0 g and 5.1 g, respectively. HCQ was demonstrated to decrease the appearance of LE-like lesions and the number of mast cells in the dermis. Furthermore, there were no obvious systemic adverse effects. This study provides evidence that suggests benefits in human patients.

Ultrasonography-guided Transthoracic Cutting Biopsy of Pulmonary Lesion: Diagnostic Benefits and Safety

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Yang, Mei Ah; Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Ohm, Joon Young [Bucheon St. Mary' s Hospital, Bucheon (Korea, Republic of)

2012-06-15

To assess the safety and usefulness of ultrasonography-guided transthoracic cutting biopsy for lung lesions. Eighty-eight patients (66 men, 22 women, mean age 59 years) with lung lesions underwent an ultrasonography(USG)-guided transthoracic cutting biopsy. The final diagnosis was based on the findings of surgery and clinical and radiological follow-ups. The histopathologic results and diagnostic accuracy of cutting biopsy were determined. Also, the complication rate was statistically evaluated according to the mass size, number of biopsies, and the presence or absence of pleural effusion. Biopsy specimens were successfully obtained in all patients. 79 of 88 lesions (89.8%) were established by histopathology. The final diagnosis was malignant in 58 and benign in 28. The remaining 2 patients were lost to follow-up. Diagnostic sensitivity for malignant lesions was 89.6% (52/58) and that for benign lesions was 96.4% (27/28). Procedure-related complications occurred in 9 patients (10.2%) including pneumothorax (n = 2) and hemoptysis (n = 7). And there was no significant difference according to mass size, number of biopsies, or presence of pleural effusion. USG-guided transthoracic cutting biopsy is a useful and safe method for technically-feasible lung lesions

Ultrasonography-guided Transthoracic Cutting Biopsy of Pulmonary Lesion: Diagnostic Benefits and Safety

International Nuclear Information System (INIS)

Yang, Mei Ah; Park, Mi Hyun; Shin, Byung Seok; Ohm, Joon Young

2012-01-01

To assess the safety and usefulness of ultrasonography-guided transthoracic cutting biopsy for lung lesions. Eighty-eight patients (66 men, 22 women, mean age 59 years) with lung lesions underwent an ultrasonography(USG)-guided transthoracic cutting biopsy. The final diagnosis was based on the findings of surgery and clinical and radiological follow-ups. The histopathologic results and diagnostic accuracy of cutting biopsy were determined. Also, the complication rate was statistically evaluated according to the mass size, number of biopsies, and the presence or absence of pleural effusion. Biopsy specimens were successfully obtained in all patients. 79 of 88 lesions (89.8%) were established by histopathology. The final diagnosis was malignant in 58 and benign in 28. The remaining 2 patients were lost to follow-up. Diagnostic sensitivity for malignant lesions was 89.6% (52/58) and that for benign lesions was 96.4% (27/28). Procedure-related complications occurred in 9 patients (10.2%) including pneumothorax (n = 2) and hemoptysis (n = 7). And there was no significant difference according to mass size, number of biopsies, or presence of pleural effusion. USG-guided transthoracic cutting biopsy is a useful and safe method for technically-feasible lung lesions

Runaway Train: A Leaky Radiosensitive SCID with Skin Lesions and Multiple Lymphomas

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Børre Fevang

2018-01-01

Full Text Available The nuclease Artemis is essential for the development of T-cell and B-cell receptors and repair of DNA double-strand breaks, and a loss of expression or function will lead to a radiosensitive severe combined immunodeficiency with no functional T-cells or B-cells (T-B-SCID. Hypomorphic mutations in the Artemis gene can lead to a functional, but reduced, T-cell and B-cell repertoire with a more indolent clinical course called “leaky” SCID. Here, we present the case of a young man who had increasingly aggressive lymphoproliferative skin lesions from 2 years of age which developed into multiple EBV+ B-cell lymphomas, where a hypomorphic mutation in the Artemis gene was found in a diagnostic race against time using whole exome sequencing. The patient was given a haploidentical stem cell transplant while in remission for his lymphomas and although the initial course was successful, he succumbed to a serious Pneumocystis jirovecii pneumonia 5 months after the transplant. The case underscores the importance of next-generation sequencing in the diagnosis of patients with suspected severe immunodeficiency.

CT-guided percutaneous transthoracic aspiration biopsy of lung lesions: factors influencing the diagnostic accuracy

International Nuclear Information System (INIS)

Huang Zhenguo; Zhang Xuezhe; Wang Wu

2006-01-01

Objective: To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods: CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up. Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors (benignancy or malignancy, size, location, depth, presence of cavity), procedure factors (laser-guidance, position of patient) and patient-related factors (sex, age, presence of emphysema); with the accuracy of the diagnosis. Results: 1)289 lesions were diagnosed as malignant ones and 146 as benign ones. The accuracy of CT-guided biopsy was 83.4%(363/435). Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were 88.9%(257/289) and 72.6%(106/146), respectively (χ 2 =18.71, P=0.00002). Laser-group was superior to non-laser group (88.4% versus 80.9%, respectively, χ 2 =4.00, P=0.0456). Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were 3.78±1.64 cm and 3.02±1.26 cm, respectively (F=13.79, P=0.0002). 2)Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses (Wald χ 2 =14.01, P=0.0002) and using laser-guidance(Wald χ 2 =3.92, P=0.0477) were significantly associated with the diagnostic accuracy. Conclusions: Final correct diagnoses (benign, malignant) are closely related to the application of laser-guidance for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy. (authors)

[Linoleic acid emulsion on the peri-lesion skin of venal ulcers. Action and cicatrizant effect. Corpus study].

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Maicas, Vicente Tormo; Rochina, Iván Julián

2008-04-01

The authors present a clinical and documented follow up on the peri-lesion skin in 44 venal blood vessel ulcers which were treated by a hyper-oxygenized fatty acid emulsion. All the elderly in this study belonged to the Number 3 Health Department of the Valencia Sanitary Council. This study's protocol and its data collection register received a favourable report from the Committee on Research Ethics at the "La Plana" Hospital. With a total percentage of 60 in essential linoleic fatty acid, CORPITOLINOL 60, is the emulsion which has the greatest quantity of this element so necessary for human skin. In effect, this is the essential fatty acid which has the greatest presence in human skin, besides being a vital element for skin hydration and its viability to form part of a fundamental structure: intercellular layers in the corneum layer of the epidermis. On the other hand, in the hyper-oxygenation process, this product helps the skin to obtain molecules very similar to prostaglandins land 2 which favour tissue perfusion. The main objective of this study has been to evaluate, after the application of this emulsion over a four week time period, the reduction of erythema and peri-lesion hyperkeratosis in venal blood vessel ulcers. But at the same time, as a secondary objective, this study evaluated peri-lesion skin based on other criteria such as pruritus, lesions due to scratching, or edema; this study verified whether treatment of peri-lesion skin influences the cicatrisation of wounds, as well as treatment acceptance by health professionals and patients. Incidences of erythemas and hyperkeratosis totally disappeared in 40% and 50% of those cases, respectively; in those lesions where these symptoms continued after four weeks of treatment there was a significant reduction in the degree of both erythemas and hyperkeratosis, 25% in each case. These researchers consider that good treatment of peri-lesion skin combined with a standard cure protocol, using "Urgotul" as the

A fractal analysis of skin pigmented lesions using the novel tool of the variogram technique

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Mastrolonardo, Mario [Department of Medical and Occupational Sciences, Unit of Dermatology, Azienda Ospedaliero-Universitaria ' Ospedali Riuniti' di Foggia (Italy)]. E-mail: mariomastrolonardo@libero.it; Conte, Elio [Department of Medical and Occupational Sciences, Unit of Dermatology, Azienda Ospedaliero-Universitaria ' Ospedali Riuniti' di Foggia (Italy); Department of Pharmacology and Human Physiology, TIRES-Center for Innovative Technology for Signal Detection and Processing, Bari University, 70100 Bari (Italy); Zbilut, Joseph P. [Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL 60612 (United States)

2006-06-15

The incidence of the cutaneous malignant melanoma is increasing rapidly in the world [Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide, Version 1.0 IARC Cancer Base no. 5. Lyon: IARC Press, 2001]. The therapeutic address requires a method having high sensitivity and capability to diagnose such disease at an early stage. We introduce a new diagnostic method based on non-linear methodologies. In detail we suggest that fractal as well as noise and chaos dynamics are the most important components responsible for genetic instability of melanocytes. As consequence we introduce the new technique of the variogram and of fractal analysis extended to the whole regions of interest of skin in order to obtain parameters able to identify the malignant lesion. In a preliminary analysis, satisfactory results are reached.

A case of stranded Indo-Pacific bottlenose dolphin (Tursiops aduncus) with lobomycosis-like skin lesions in Kinko-wan, Kagoshima, Japan.

Science.gov (United States)

Tajima, Yuko; Sasaki, Kyoko; Kashiwagi, Nobuyuki; Yamada, Tadasu K

2015-08-01

Lobomycosis is a chronic fungal disease caused by the etiologic agent, Lacazia loboi, in the skin and subcutaneous tissues in humans and dolphins in tropical and transitional tropical climates. An Indo-Pacific bottlenose dolphin (Tursiops aduncus) stranded in Kagoshima, Japan, had severe skin lesions characterized by granulomatous reactions and hyperkeratosis that were similar to those of the lobomycosis, but no fungal organism was observed in the skin lesion. In this paper, we report a stranded Indo-Pacific bottlenose dolphin with lobomycosis-like lesions based on pathological examinations in Japan.

A case of stranded Indo-Pacific bottlenose dolphin (Tursiops aduncus) with lobomycosis-like skin lesions in Kinko-wan, Kagoshima, Japan

Science.gov (United States)

TAJIMA, Yuko; SASAKI, Kyoko; KASHIWAGI, Nobuyuki; YAMADA, Tadasu K.

2015-01-01

Lobomycosis is a chronic fungal disease caused by the etiologic agent, Lacazia loboi, in the skin and subcutaneous tissues in humans and dolphins in tropical and transitional tropical climates. An Indo-Pacific bottlenose dolphin (Tursiops aduncus) stranded in Kagoshima, Japan, had severe skin lesions characterized by granulomatous reactions and hyperkeratosis that were similar to those of the lobomycosis, but no fungal organism was observed in the skin lesion. In this paper, we report a stranded Indo-Pacific bottlenose dolphin with lobomycosis-like lesions based on pathological examinations in Japan. PMID:25866402

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing.

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Tian, Panwen; Wang, Ye; Li, Lei; Zhou, Yongzhao; Luo, Wenxin; Li, Weimin

2017-02-01

Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions. This study included CT-guided TCNB with 18-gauge cutting needles in 560 consecutive patients with small (≤3 cm) pulmonary lesions from January 2012 to January 2015. There were 323 males and 237 females, aged 51.8±12.7 years. The size of the pulmonary lesions was 1.8±0.6 cm. The sensitivity, specificity, accuracy and complications of the biopsies were investigated. The risk factors of diagnostic failure were assessed using univariate and multivariate analyses. The sample's adequacy for molecular testing of non-small cell lung cancer (NSCLC) was analyzed. The overall sensitivity, specificity, and accuracy for diagnosis of malignancy were 92.0% (311/338), 98.6% (219/222), and 94.6% (530/560), respectively. The incidence of bleeding complications was 22.9% (128/560), and the incidence of pneumothorax was 10.4% (58/560). Logistic multivariate regression analysis showed that the independent risk factors for diagnostic failure were a lesion size ≤1 cm [odds ratio (OR), 3.95; P=0.007], lower lobe lesions (OR, 2.83; P=0.001), and pneumothorax (OR, 1.98; P=0.004). Genetic analysis was successfully performed on 95.45% (168/176) of specimens diagnosed as NSCLC. At least 96.8% of samples with two or more passes from a lesion were sufficient for molecular testing. The diagnostic yield of small pulmonary lesions by CT-guided TCNB is high, and the procedure is relatively safe. A lesion size ≤1 cm, lower lobe lesions, and pneumothorax are independent risk factors for biopsy diagnostic failure. TCNB specimens could provide adequate tissues for molecular testing.

Dermatoses em pacientes com diabetes mellitus Skin lesions in diabetic patients

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N T Foss

2005-08-01

Full Text Available OBJETIVO: Ainda é desconhecida a relação do diabetes com fatores determinantes ou precipitantes de lesões dermatológicas em pacientes diabéticos. Assim, o objetivo do estudo foi investigar a presença de lesões cutâneas, não referidas pelo paciente diabético e sua relação com o controle metabólico da doença. MÉTODOS: Foram examinados 403 pacientes, dos quais 31% eram diabéticos do tipo 1 e 69% do tipo 2. Em ambulatório de um hospital universitário, os pacientes foram atendidos por endocrinologista para a avaliação endócrino-metabólica e por dermatologista para a avaliação dermatológica. O grau de controle metabólico foi documentado em 136 pacientes por meio da dosagem de hemoglobina glicada. RESULTADOS: Houve predomínio de dermatofitoses (82,6%, seguido de grupo de dermatoses como acne e degeneração actínica (66,7%, piodermites (5%, tumores cutâneos (3% e necrobiose lipoídica (1%. Entre as dermatoses mais comuns em diabéticos, foram confirmados com exame histológico: dois diagnósticos de necrobiose (0,4%, cinco de dermopatia diabética (1,2% e três casos de mal perfurante plantar (0,7%. Os valores da hemoglobina glicada foram: 7,2% em pacientes com controle metabólico adequado nos dois tipos de diabetes e de 11,9% e 12,7% nos tipos 1 e 2, respectivamente, com controle inadequado. Nos pacientes com controle metabólico inadequado foi observada freqüência maior de dermatofitoses, em ambos os tipos de diabetes. CONCLUSÕES: Os dados revelaram freqüência elevada de lesão dermatológica nos pacientes diabéticos, especialmente dermatofitoses. Dessa forma, o descontrole metabólico do diabético propicia maior suscetibilidade a infecções cutâneas.OBJECTIVE: It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their

Effect of rubber flooring on group-housed sows' gait and claw and skin lesions.

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Bos, E-J; van Riet, M M J; Maes, D; Millet, S; Ampe, B; Janssens, G P J; Tuyttens, F A M

2016-05-01

This study evaluated the influence of floor type on sow welfare in terms of lameness, claw lesions, and skin lesions. In a 2 × 3 factorial design, we have investigated the effect of rubber coverings on concrete floors and the effect of 3 levels of dietary zinc supplementation on locomotion and claw and skin lesions in group-housed sows. Six groups of 21 ± 4 hybrid sows were monitored during 3 successive reproductive cycles. The sows were group housed from d 28 after insemination (d 0) until 1 wk before expected farrowing date (d 108) in pens with either exposed concrete floors or concrete floors covered with rubber in part of the lying area and the fully slatted area. During each reproductive cycle, locomotion and skin lesions were assessed 4 times (d 28, 50, 108, and 140) and claw lesions were assessed twice (d 50 and 140). Results are given as least squares means ± SE. Locomotion and claw scores were given in millimeters, on analog scales of 150 and 160 mm, respectively. Here, we report on the effect of floor type, which did not interact with dietary zinc concentration ( > 0.10 for all variables). At move to group (d 28) and mid gestation (d 50), no differences between floor treatments were seen in locomotion ( > 0.10). At the end of gestation (d 108), sows housed on rubber flooring scored 9.9 ± 4.1 mm better on gait ( flooring at mid gestation (d 50). However, sows on rubber flooring scored worse for "vertical cracks in the wall horn" (difference of 3.4 ± 1.7 mm; = 0.04). At the end of lactation (d 140), both "white line" (difference of 2.9 ± 1 mm; = 0.02) and "claw length" (difference of 4.7 ± 1.4 mm; flooring. No differences for skin lesions were observed between floor treatments. The improved scores for gait toward the end of gestation and some types of claw disorders at mid gestation suggest that rubber flooring in group housing has a beneficial effect on the overall leg health of sows. The documented increase in vertical cracks in the wall horn at d

Elemental concentration in normal skin and fibroepithelial polip lesions by synchrotron radiation total reflection X-ray fluorescence technique

International Nuclear Information System (INIS)

Soares, Julio C.A.C.R.; Canellas, Catarine G.L.; Lopes, Ricardo T.; Anjos, Marcelino J.

2011-01-01

In this work, the concentrations of trace elements were measured in acrochordon, a skin lesion also known as skin tag or fibroepithelial polyp, as well as in normal skin from the same patient. The samples were analysed by Synchrotron Radiation Total Reflection X- ray Fluorescence (SRTXRF) in the Synchrotron Light National Laboratory (LNLS) in Campinas/Sao Paulo-Brazil. The collection of lesion and healthy skin samples, including papillary dermis and epidermis, has involved 17 patients. It was evaluated the presence of P, S, Cl, K, Ca, Cr, Mn, Fe, Cu, Zn, Br and Rb in the paired samples, which were compared, and significant differences were found in some of them. (author)

mHealth App for Risk Assessment of Pigmented and Nonpigmented Skin Lesions-A Study on Sensitivity and Specificity in Detecting Malignancy.

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Thissen, Monique; Udrea, Andreea; Hacking, Michelle; von Braunmuehl, Tanja; Ruzicka, Thomas

2017-12-01

With the advent of smartphone devices, an increasing number of mHealth applications that target melanoma identification have been developed, but none addresses the general context of melanoma and nonmelanoma skin cancer identification. In this study a smartphone application using fractal and classical image analysis for the risk assessment of skin lesions is systematically evaluated to determine its sensitivity and specificity in the diagnosis of melanoma and nonmelanoma skin cancer along with actinic keratosis and Bowen's disease. In the Department of Dermatology, Catharina Hospital Eindhoven, The Netherlands, 341 melanocytic and nonmelanocytic lesions were imaged using SkinVision app; 239 underwent histopathological examination, while the rest of 102 lesions were clinically diagnosed as clearly benign and not removed. The algorithm has been calibrated using the images of the first 233 lesions. The calibrated version of the algorithm was used in a subset of 108 lesions, and the obtained results were compared with the medical findings. On the 108 cases used for evaluation the algorithm scored 80% sensitivity and 78% specificity in detecting (pre)malignant conditions. Although less accurate than the dermatologist's clinical eye, the app may offer support to other professionals who are less familiar with differentiating between benign and malignant lesions. An mHealth application for the risk assessment of skin lesions was evaluated. It adds value to diagnosis tools of its type by taking into consideration pigmented and nonpigmented lesions all together and detecting signs of malignancy with high sensitivity.

Topical retapamulin in the management of infected traumatic skin lesions

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Ribhi Shawar

2008-12-01

Full Text Available Ribhi Shawar1, Nicole Scangarella-Oman1, MaryBeth Dalessandro2, John Breton2, Monique Twynholm3, Gang Li4, Harmony Garges51Infectious Disease Center for Excellence in Drug Discovery, GlaxoSmithKline, Collegeville, PA, USA; 2Anti-infectives Medicine Development Center, GlaxoSmithKline, Collegeville, PA, USA; 3Infectious Diseases Medicine Development Centre Europe, GlaxoSmithKline, Greenford, Middlesex, UK; 4MDC BDS – Infectious Disease, GlaxoSmithKline, Collegeville, PA, USA; 5Anti-infectives Medicine Development Center, GlaxoSmithKline, Research Triangle Park, NC, USAAbstract: Retapamulin is a novel semisynthetic pleuromutilin antibiotic specifically designed for use as a topical agent. The unique mode of action by which retapamulin selectively inhibits bacterial protein synthesis differentiates it from other nonpleuromutilin antibacterial agents that target the ribosome or ribosomal factors, minimizing the potential for target-specific cross-resistance with other antibacterial classes in current use. In vitro studies show that retapamulin has high potency against the Gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes, and coagulase-negative staphylococci commonly found in skin and skin-structure infections (SSSIs, including S. aureus strains with resistance to agents such as macrolides, fusidic acid, or mupirocin, and other less common organisms associated with SSSIs, anaerobes, and common respiratory tract pathogens. Clinical studies have shown that twice-daily topical retapamulin for 5 days is comparable to 10 days of oral cephalexin in the treatment of secondarily infected traumatic lesions. A 1% concentration of retapamulin ointment has been approved for clinical use as an easily applied treatment with a short, convenient dosing regimen for impetigo. Given the novel mode of action, low potential for cross-resistance with established antibacterial agents, and high in vitro potency against many bacterial pathogens

Improved detection reveals active β-papillomavirus infection in skin lesions from kidney transplant recipients.

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Borgogna, Cinzia; Lanfredini, Simone; Peretti, Alberto; De Andrea, Marco; Zavattaro, Elisa; Colombo, Enrico; Quaglia, Marco; Boldorini, Renzo; Miglio, Umberto; Doorbar, John; Bavinck, Jan N Bouwes; Quint, Koen D; de Koning, Maurits N C; Landolfo, Santo; Gariglio, Marisa

2014-08-01

The aim of this study was to determine whether detection of β-HPV gene products, as defined in epidermodysplasia verruciformis skin cancer, could also be observed in lesions from kidney transplant recipients alongside the viral DNA. A total of 111 samples, corresponding to 79 skin lesions abscised from 17 kidney transplant recipients, have been analyzed. The initial PCR analysis demonstrated that β-HPV-DNA was highly present in our tumor series (85%). Using a combination of antibodies raised against the E4 and L1 proteins of the β-genotypes, we were able to visualize productive infection in 4 out of 19 actinic keratoses, and in the pathological borders of 1 out of 14 squamous cell carcinomas and 1 out of 31 basal cell carcinomas. Increased expression of the cellular proliferation marker minichromosome maintenance protein 7 (MCM7), that extended into the upper epithelial layers, was a common feature of all the E4-positive areas, indicating that cells were driven into the cell cycle in areas of productive viral infections. Although the present study does not directly demonstrate a causal role of these viruses, the detection of E4 and L1 positivity in actinic keratosis and the adjacent pathological epithelium of skin cancer, clearly shows that β-HPV are actively replicating in the intraepidermal precursor lesions of kidney transplant recipients and can therefore cooperate with other carcinogenic agents, such as UVB, favoring skin cancer promotion.

Mammotome biopsy under ultrasound control in the diagnostics and treatment of nodular breast lesions - own experience.

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Kibil, Wojciech; Hodorowicz-Zaniewska, Diana; Kulig, Jan

2012-05-01

Mammotome biopsy is an effective, minimally invasive, novel technique used in the verification of breast lesions.The aim of the study was to assess the value of ultrasound-guided vacuum-assisted core needle biopsy (mammotome biopsy) in the diagnostics and treatment of nodular breast lesions, considering own data.Material and methods. Analysis comprised 1183 mammotome biopsies under ultrasound control performed in 1177 female patients during the period between 2000 and 2010, at the Regional Clinic for Early Diagnostics and Treatment of Breast Lesions, I Chair and Department of General Surgery, Jagiellonian University, Collegium Medicum.Results. The average patient age amounted to 41.7 years. The size of the investigated lesions ranged between 4 and 65 mm (mean - 12 mm). The histopathological examination result was as follows: fibrocystic lesions (n=285), adenofibroma (n=477), adenosis sclerosans (n=188), hyperplasia without atypy (n=58), phyllode tumor (n=2), papilloma (n=14), hamartoma (n=1), atypical hyperplasia (n=25), in situ ductal carcinoma (n=4), in situ lobular carcinoma (n=5), infiltrating ductal carcinoma (n=114), infiltrating lobular carcinoma (n=4), non-diagnostic result (n=6). The histopathological diagnosis was obtained in 99.5% of cases. Patients diagnosed with atypical hyperplasia or cancer were qualified for surgery, according to accepted standards. The presence of a hematoma was the most common complication after the biopsy, observed in 16.5% of patients.Conclusions. The obtained results confirmed the high value of ultrasound-guided biopsies in the diagnostics of nodular breast lesions. The method is safe, minimally invasive, with few complications, providing a good cosmetic effect. In case of benign lesions with a diameter of less than 15 mm the mammotome biopsy enables to completely excise the lesions, being an alternative to open surgical biopsies. The mammotome biopsy should become the method of choice considering the diagnostics of nodular

Lesion type and reader experience affect the diagnostic accuracy of breast MRI: A multiple reader ROC study

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Baltzer, Pascal A.T., E-mail: patbaltzer@gmail.com [Department of Biomedical Imaging and Imge-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Kaiser, Werner Alois [Department of Diagnostic and Interventional Radiology, University Hospital Jena, Erlanger Allee 101, 07740 Jena (Germany); Dietzel, Matthias, E-mail: dietzelmatthias2@hotmail.com [Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen (Germany)

2015-01-15

Highlights: • The main findings of our study are, that reader experience and lesion type (i.e., mass versus non-mass enhancement) are independent predictors of the diagnostic accuracy of breast MRI. • Specifically, benign and malignant non-mass lesions cannot be differentiated with sufficient accuracy, especially if readers are not experienced. • We conclude that future research in breast MRI should focus on non-mass lesions, as these are the problem makers in modern breast MRI. - Abstract: Purpose: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. Materials and methods: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n = 103). Six blinded readers (experience level, high (HE, n = 2); intermediate (IE, n = 2); and low (LE, n = 2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. Results: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P < 0.0001) and

Dermatitis Herpetiformis: From the Genetics to the Development of Skin Lesions

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Diletta Bonciani

2012-01-01

Full Text Available Dermatitis herpetiformis (DH is a rare autoimmune disease linked to gluten sensitivity with a chronic-relapsing course. It is currently considered to be the specific cutaneous manifestation of celiac disease (CD. Both conditions are mediated by the IgA class of autoantibodies, and the diagnosis of DH is dependent on the detection of granular deposits of IgA in the skin. There is an underlying genetic predisposition to the development of DH, but environmental factors are also important. This paper describes these different factors and discusses the known mechanism that lead to the development of skin lesions.

Expression and Localization of Peroxisome Proliferator-Activated Receptors and Nuclear Factor κB in Normal and Lesional Psoriatic Skin

DEFF Research Database (Denmark)

Westergaard, Majken; Henningsen, Jeanette; Johansen, Claus

2003-01-01

Abnormal epidermal proliferation and differentiation characterize the inflammatory skin disease psoriasis. Here we demonstrate that expression of PPARdelta mRNA and protein is markedly upregulated in psoriatic lesions and that lipoxygenase products accumulating in psoriatic lesions are potent...... activators of PPARdelta. The expression levels of NF-kappaB p50 and p65 were not significantly altered in lesional compared with nonlesional psoriatic skin. In the basal layer of normal epidermis both p50 and p65 were sequestered in the cytoplasm, whereas p50, but not p65, localized to nuclei...... in the suprabasal layers, and this distribution was maintained in lesional psoriatic skin. In normal human keratinocytes PPAR agonists neither impaired IL-1beta-induced translocation of p65 nor IL-1beta-induced NF-kappaB DNA binding. We show that PPARdelta physically interacts with the N-terminal Rel homology...

Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: Assessment of the additional diagnostic value of contrast-enhanced ultrasound in the non-cirrhotic liver

International Nuclear Information System (INIS)

Quaia, Emilio; De Paoli, Luca; Angileri, Roberta; Cabibbo, Biagio; Cova, Maria Assunta

2014-01-01

Objective: To assess the additional diagnostic value of contrast-enhanced ultrasound (CEUS) in the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography (CT). Methods: Fifty-five solid hepatic lesions (1–4 cm in diameter) in 46 non-cirrhotic patients (26 female, 20 male; age ± SD, 55 ± 10 years) underwent CEUS after being detected on contrast-enhanced CT which was considered as non-diagnostic after on-site analysis. Two blinded independent readers assessed CT and CEUS scans and were asked to classify retrospectively each lesion as a malignant or benign based on reference diagnostic criteria for the different hepatic lesion histotypes. Diagnostic accuracy and confidence (area – A z – under ROC curve) were assessed by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging (n = 30 lesions), histology (n = 7 lesions), or US follow-up (n = 18 lesions) as the reference standards. Results: Final diagnoses included 29 hemangiomas, 3 focal nodular hyperplasias, 1 hepatocellular adenoma, and 22 metastases. The additional review of CEUS after CT images improved significantly (P < .05) the diagnostic accuracy (before vs after CEUS review = 49% [20/55] vs 89% [49/55] – reader 1 and 43% [24/55] vs 92% [51/55] – reader 2) and confidence (A z , 95% Confidence Intervals before vs after CEUS review = .773 [.652–.895] vs .997 [.987–1] – reader 1 and .831 [.724–.938] vs .998 [.992–1] – reader 2). Conclusions: CEUS improved the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced CT by identifying some specific contrast enhancement patterns.

CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

International Nuclear Information System (INIS)

Niu, Xiang Ke; Bhetuwal, Anup; Yang, Han Feng

2015-01-01

The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

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Niu, Xiang Ke [Dept. of Radiology, Affiliated Hospital of Chengdu University, Chengdu (China); Bhetuwal, Anup; Yang, Han Feng [Dept. of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong (China)

2015-02-15

The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

An Improved Mouse Model of Atopic Dermatitis and Suppression of Skin Lesions by an Inhibitor of Tec Family Kinases

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Yuko Kawakami

2007-01-01

Conclusions: We established a highly efficient, highly reproducible protocol to induce skin lesions in NC/Nga mice and successfully applied it to show the efficacy of terreic acid in treating skin lesions. This mouse model of atopic dermatitis will be useful to study the pathogenetic processes of atopic dermatitis and to evaluate the efficacy of drug candidates.

Prevalence and Characteristics of Nonblanching, Palpable Skin Lesions With a Linear Pattern in Children With Henoch-Schönlein Syndrome.

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Milani, Gregorio P; Lava, Sebastiano A G; Ramelli, Vera; Bianchetti, Mario G

2017-11-01

Linear nonblanching skin lesions are thought to occur very rarely in patients with Henoch-Schönlein syndrome. To examine the prevalence and characteristics of linear nonblanching skin lesions in children with Henoch-Schönlein syndrome. A prospective case series was conducted at the ambulatory practice of a hospitalist between January 1, 2010, and December 31, 2015, among 31 consecutive children with Henoch-Schönlein syndrome. Thirty-one consecutive children affected with Henoch-Schönlein syndrome who were from 3.0 to 12.0 years of age (median age, 6.2 years). Children with Henoch-Schönlein syndrome underwent a careful, structured skin examination established in advance with emphasis on the presence of palpable lesions with a linear pattern. Among the 31 children in the study (12 girls and 19 boys; median age, 6.2 years [range, 3.0-12.0 years]), 8 (26%) had linear lesions on the legs, groin, waistline, wrists, or forearms. Patients with or without linear lesions did not differ significantly with respect to sex, age, and cutaneous, abdominal, articular, or renal involvement. This study illustrates the prevalence and characteristics of linear skin lesions in patients with Henoch-Schönlein syndrome. Patients with symptoms suggestive of this vasculitis should be evaluated for the presence of nonblanching, palpable lesions with a linear pattern.

New patient pathway using vacuum-assisted biopsy reduces diagnostic surgery for B3 lesions

International Nuclear Information System (INIS)

Rajan, S.; Shaaban, A.M.; Dall, B.J.G.; Sharma, N.

2012-01-01

Aim: To assess the clinical impact of a new patient management pathway incorporating vacuum-assisted biopsy for lesions of uncertain malignant potential (B3). Materials and methods: A retrospective analysis was undertaken of all B3 lesions on core biopsy in the pathology database from April 2008 to April 2010. Outcome measures assessed included final histological diagnosis, frequency of diagnostic surgical biopsy, and impact on management. Results: In the old pathway, there were 95 B3 lesions, of which 14% (13/95) were planned for vacuum-assisted biopsy and 86% (82/95) for surgical biopsy. In the new pathway, there were 94 B3 lesions, of which 68% (64/94) were planned for vacuum-assisted biopsy and 32% (30/94) for surgical biopsy. Following further sampling with vacuum-assisted biopsy, only 13% of patients required diagnostic surgical biopsy and in 25% of cases, a preoperative diagnosis of carcinoma was reached allowing patients to proceed to therapeutic surgery. Conclusion: The new pathway has reduced the number of benign diagnostic surgical biopsies performed and increased the preoperative diagnosis of breast cancer.

Segmentation of skin lesions in chronic graft versus host disease photographs with fully convolutional networks

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Wang, Jianing; Chen, Fuyao; Dellalana, Laura E.; Jagasia, Madan H.; Tkaczyk, Eric R.; Dawant, Benoit M.

2018-02-01

Chronic graft-versus-host disease (cGVHD) is a frequent and potentially life-threatening complication of allogeneic hematopoietic stem cell transplantation (HCT) and commonly affects the skin, resulting in distressing patient morbidity. The percentage of involved body surface area (BSA) is commonly used for diagnosing and scoring the severity of cGVHD. However, the segmentation of the involved BSA from patient whole body serial photography is challenging because (1) it is difficult to design traditional segmentation method that rely on hand crafted features as the appearance of cGVHD lesions can be drastically different from patient to patient; (2) to the best of our knowledge, currently there is no publicavailable labelled image set of cGVHD skin for training deep networks to segment the involved BSA. In this preliminary study we create a small labelled image set of skin cGVHD, and we explore the possibility to use a fully convolutional neural network (FCN) to segment the skin lesion in the images. We use a commercial stereoscopic Vectra H1 camera (Canfield Scientific) to acquire 400 3D photographs of 17 cGVHD patients aged between 22 and 72. A rotational data augmentation process is then applied, which rotates the 3D photos through 10 predefined angles, producing one 2D projection image at each position. This results in 4000 2D images that constitute our cGVHD image set. A FCN model is trained and tested using our images. We show that our method achieves encouraging results for segmenting cGVHD skin lesion in photographic images.

Acute skin lesions due to localized ''hot particle'' radiation exposures

International Nuclear Information System (INIS)

Baum, J.W.; Carsten, A.L.; Kaurin, D.G.L.; Schaefer, C.W.

1996-01-01

Purpose of the studies was to determine incidence and severity of lesions resulting from localized deposition of dose to the skin from small ( 2 at 70μm depth) from isotopes having max beta particle energies from about 0.3-3 MeV. Incidence of erythema and scabs (indicating ulceration) were scored routinely for up to 71 days post-irradiation. Responses followed normal probability distributions, and thus, no true threshold could be defined. Ten and 50% incidence rates were deduced using probit analyses. Lowest dose producing 10% incidence was about 1 Gy for exposures to Yb-175 (0.5 MeV max energy) beta particles. Severity of lesions was estimated using diameters and persistence. From preliminary considerations of probability of induction, size, and persistence of acute lesions, a special limit for hot particle exposures in the range of 5-50 Gy may be reasonable, with an action level between about 1 Gy and the limit

Skin rash and arthritis a simplified appraisal of less common associations.

Science.gov (United States)

Cozzi, A; Doria, A; Gisondi, P; Girolomoni, G

2014-06-01

Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information. © 2013 European Academy of Dermatology and Venereology.

The dependence of skin lesions on the depth-dose distribution from β-irradiation of people in the Chernobyl nuclear power plant accident

International Nuclear Information System (INIS)

Barabanova, A.

1990-01-01

A detailed study was made of conditions of exposure of 56 Chernobyl victims who suffered skin radiation lesions. The most typical conditions were experimentally reconstructed to investigate specific characteristics of dose distribution to the skin according to depth for different exposure conditions. Absorbed doses at depths of 7 mg cm -2 and 150 mg cm -2 were calculated on the basis of measurements with multilayer skin dosemeters. Patients were classified into four groups. Dosimetric characteristics for each group were compared with clinical pictures to establish critical factors in the occurrence of lesions. It was demonstrated that depth-dose distribution of β-radiation to the skin is of great influence not only for early effects of radiation but also for later effects. Radiation lesions in the skin led to death if the area of the lesions exceeded about 50% total body surface, and if doses to the skin were about 200-300 Gy at 7 mg cm -2 and more than about 30 Gy at 150 mg cm -2 . (author)

Diagnostic utility of medical thoracoscopy in peripheral parenchymal pulmonary lesions

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E. Hatata

2015-07-01

Conclusions: Among patients with peripheral parenchymal pulmonary lesions remaining undiagnosed after usual initial investigation and even transthoracic needle biopsies, thoracoscopy done under local anaesthesia is a rapid, safe, and well-tolerated procedure with an excellent diagnostic yield that is equivalent to that of thoracotomy.

SKIBO diseases: a concept to avoid bloody diagnostic procedures in ambiguous skeletal lesions

International Nuclear Information System (INIS)

Freyschmidt, J.; Freyschmidt-Paul, P.

2001-01-01

In cases with an ''atypical'' radiologic pattern-osteolytic as well as osteosclerotic or mixed - the radiologist should pay attention to the patient's skin. There he will often find specific changes that are the key to a correct interpretation of the radiologic abnormalities. In such cases the synopsis is of more value in differential diagnosis than more or less unspecific histologic findings. Entities with a non-arbitrary conjunction of changes of the skin and bones we call SKIBO diseases. Some of them have a high potential for mimicking malignant bone lesions, often with the consequence of unnecessary biopsies. In this article we present the typical dermatologic and radiologic signs and symptoms of neurofibromatosis, sarcoidosis and pustulotic arteroosteitis (PAO) with special focus on such skeletal lesions that may mimic malignancy. (orig.)

Skin

International Nuclear Information System (INIS)

Hunter, R.D.

1985-01-01

Malignant disease involving the skin represents a significant work load to the general radiotherapist and can involve interesting diagnostic and therapeutic decisions. Primary skin cancer is also relatively common and there is a need to provide an efficient service in which the first treatment is successful in the majority of patients. The reward for careful attention to technique is very considerable both in terms of clinical cancer control and functional results. Squamous cell carcinoma, basal cell carcinoma, and intra-epidermal carcinoma constitute the majority of the lesions dealt with clinically, but metastatic disease, lymphomas, and malignant melanomas are also referred regularly for opinions and may require radiotherapy. The general principle of the techniques of assessment and radiotherapeutic management to be described are equally applicable to any malignant skin tumour once the decision has been made to accept it for radiotherapy. Dosage and fractionation may have to be adjusted to allow for the nature of the disease process and the intent of the treatment

Multiple Erythema Lesions Obscured As Fungal Skin Infection

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Allma Koçinaj

2014-09-01

Full Text Available Erythema migrans is a ring like erythema, with a few centimeters in diameter. Usually it occur solitary, days to weeks after an infected tick bite. According to skin changes it can be manifested acutely such as erythema migrans in Lyme Borreliosis, borrelial lymphocytoma (subacute, or as a late Lyme disease with acrodermatitis chronica atrophicans. All stages of this disease can be treatable with antimicrobial agents. As a first case in our department with multiple lesions, we describe a 14-year-old female and review the patient’s clinical and laboratory features, the causes of the disease, diagnosis as well as treatment.

Diagnostic sensitivity and specificity in a retrospective clinical, radiographic and histopathological study of 166 cystic jaw lesions

DEFF Research Database (Denmark)

Therkildsen, N. M.; Andersen, Kristian; Blomlôf, J.

2014-01-01

, but a low diagnostic sensitivity in relation to the keratocystic odontogenic tumour (KCOT) was revealed. The radicular cyst, dentigerous cyst and KCOT were the most frequently observed cystic jaw lesions. Conclusion In general, a high diagnostic specificity for all cystic jaw lesions was observed. A low...

A Case Report: Krukenberg Tumour with Nodular Skin Lesions

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Özden Demir

2017-03-01

Full Text Available The Krukenberg tumor is a rare variety of metastatic cancer to the ovary. The stomach is the most common site for the primary tumor, followed by the breast, gall bladder, colon and pancreas. It is not always possible to distinguish ovarian metastasis from primary ovarian masses in patients in whom the malignancy center is unidentified. This case report firstly aims to present a patient who presented with common nodular skin lesions, migrating arthritis and severe clinical characteristics, and diagnosed with Krukenberg tumor with further examinations.

Comparison of diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration cytology and cell block in solid lesions

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Avinash Bhat Balekuduru

2017-01-01

Full Text Available Background and Aim: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA is a procedure of choice for the diagnostic evaluation of submucosal and periluminal lesions. Tissue sample can be obtained by EUS-FNA cytology (FNAC or cell block (CB. The aim of the present study is to compare diagnostic yield of EUS-FNA CB and cytology in the absence of onsite pathologist following a protocol-based EUS-FNA approach in solid lesions. Patients and Methods: Participants who underwent EUS-FNA at our center for solid submucosal or periluminal lesions (pancreas, lymph node, and liver between 2014 and 2016 were included, retrospectively. The indication for the procedure along with the clinical and other investigation details and the final etiological diagnosis were recorded on uniform structured data forms. The diagnostic yield of cytology and CB were compared using McNemar's test. The P < 0.05 was considered statistically significant. Results: EUS-FNA for solid lesion was performed in 130 lesions in 101 patients during the study period. Their mean age was 52.5 ± 12 years and 42.5% were female. Pancreatic masses were the most common lesions (37.7% followed by lymph nodes (36.9%. Submucosal lesions (17.7% and liver lesions (7.7% accounted for rest of the cases. The overall diagnostic yield for EUS-FNAC (70% and CB (74.6% was not significantly different (P = 0.3 and their combined yield was 85.3%. For the 23 patients with submucosal lesion, diagnostic yield of CB (82.6% was significantly better than cytology (47.8%, P = 0.04. Conclusions: EUS-guided CB has better yield compared to cytology in gastrointestinal submucosal lesions. The combination of CB with cytology improves the overall yield of the procedure; and hence, they should be considered complimentary rather than alternatives.

Diagnostic evaluation of rare lesions of the arteria poplitea

International Nuclear Information System (INIS)

Schmitt, R.; Christopoulos, G.; Froehner, S.; Binder, F.; Schweiger, H.

2001-01-01

Clinical and radiological findings of six patients are discussed who, due to a specific pathology of the arteria poplitea, developed claudicatio primarily in the lower leg. Applying MS-CT and MRI, the following lesions of the arteria poplitea wer found: bilateral aneurysm verum (1 case), unilateral aneurysm spurium (1 case), the arteria magna syndrome (1 case), entrapment syndrome (2 cases), and cystic adventitia degeneration. The outstanding diagnostic value of MR angiography combined with MR imaging is explained. Good knowledge of the specific pathology of the arteria poplitea is pre-requisite of efficient diagnostic evaluation, and prevention of thromboembolic complications, or ineffective therapy. (orig./CB) [de

CYCLO-OXYGENASE 2 IS PRESENT IN THE MAJORITY OF LESIONAL SKIN FROM PATIENTS WITH AUTOINMUNE BLISTERING DISEASES

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Ana Maria Abreu Velez

2013-10-01

Full Text Available Introduction: The in situ immune response within skin biopsies from patients affected by autoimmune skin blistering diseases (ABDs is not well characterized. Aim: Based on the fact that the ABD immune response is considered an adaptive immune response, both an innate immune response and inflammation would be expected in these diseases. Our investigation investigates the presence of cyclo-oxygenase-2 (COX-2, since this enzyme is commonly involved in innate immune responses. Methods: We utilized immunohistochemistry (IHC to evaluate the presence of COX-2 in lesional skin biopsies of patients affected by ABDs. We tested 30 patients with endemic pemphigus foliaceus (EPF, 15 controls from the endemic area, and 15 biopsies from healthy controls from the USA. We also tested archival biopsies from patients with selected ABDs, including 20 patients with bullous pemphigoid, 20 with pemphigus vulgaris, 8 with pemphigus foliaceus and 12 with dermatitis herpetiformis. Results: Most ABD biopsies stained positive for COX-2 in the lesional blister and/or the dermal inflammatory infiltrate, accentuated in the upper neurovascular plexus. In BP and EPF, the COX-2 staining was also seen in the sweat glands. All controls were negative. Conclusions: We document that COX-2 is expressed in lesional skin of patients with ABDs.

Increased numbers of CD4+ and CD8+ T cells in lesional skin of cats with allergic dermatitis.

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Roosje, P J; van Kooten, P J; Thepen, T; Bihari, I C; Rutten, V P; Koeman, J P; Willemse, T

1998-07-01

The aim of this study was to characterize T cells in the skin of cats with an allergic dermatitis histologically compatible with atopic dermatitis, since T cells play an important role in the pathogenesis of atopic dermatitis in humans. We observed a significantly greater number of T cells in lesional skin of domestic short-haired cats with allergic dermatitis (n = 10; median age 5.8 years) than in the skin of healthy control animals (n = 10; median age 5.0 years). In the skin of the healthy control animals, one or two CD4+ cells and no CD8+ cells were found. A predominant increase of CD4+ T cells and a CD4+/CD8+ ratio (mean +/- SD: 3.9 +/- 2.0) was found in the lesional skin of 10 cats with allergic dermatitis. The CD4+/CD8+ cell ratio in the skin of healthy control animals could not be determined because of the absence of CD8+ cells. The CD4+/CD8+ cell ratio in the peripheral blood of 10 cats with allergic dermatitis (mean +/- SD: 1.9 +/- 0.4) did not differ significantly from that in 10 healthy control animals (2.2 +/- 0.4). The CD4+/CD8+ cell ratio and predominance of CD4+ T cells in the lesional skin of cats with allergic dermatitis is comparable to that found in atopic dermatitis in humans. In addition, the observed increase of CD4+ T cells in the nonlesional skin of cats with allergic dermatitis compared to the skin of healthy cats is similar to what is seen in humans. Cytokines produced by T cells and antigen-specific T cells are important mediators in the inflammatory cascade resulting in atopic dermatitis in humans. This study is a first step to investigate their role in feline allergic dermatitis.

Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions

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Bandos, Andriy I.; Ganott, Marie A.; Sumkin, Jules H.; Kelly, Amy E.; Catullo, Victor J.; Rathfon, Grace Y.; Lu, Amy H.; Gur, David

2013-01-01

Purpose: To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Materials and Methods: Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31–60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS–based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy–based area under the receiver operating characteristic (ROC) curve. Results: Average probability-of-malignancy–based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P tomosynthesis, more cancers were classified as BI-RADS category 5 (39% [226 of 576] vs 33% [188

Diagnostic accuracy of optical coherence tomography in actinic keratosis and basal cell carcinoma.

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Olsen, J; Themstrup, L; De Carvalho, N; Mogensen, M; Pellacani, G; Jemec, G B E

2016-12-01

Early diagnosis of non-melanoma skin cancer (NMSC) is potentially possible using optical coherence tomography (OCT) which provides non-invasive, real-time images of skin with micrometre resolution and an imaging depth of up to 2mm. OCT technology for skin imaging has undergone significant developments, improving image quality substantially. The diagnostic accuracy of any method is influenced by continuous technological development making it necessary to regularly re-evaluate methods. The objective of this study is to estimate the diagnostic accuracy of OCT in basal cell carcinomas (BCC) and actinic keratosis (AK) as well as differentiating these lesions from normal skin. A study set consisting of 142 OCT images meeting selection criterea for image quality and diagnosis of AK, BCC and normal skin was presented uniformly to two groups of blinded observers: 5 dermatologists experienced in OCT-image interpretation and 5 dermatologists with no experience in OCT. During the presentation of the study set the observers filled out a standardized questionnaire regarding the OCT diagnosis. Images were captured using a commercially available OCT machine (Vivosight ® , Michelson Diagnostics, UK). Skilled OCT observers were able to diagnose BCC lesions with a sensitivity of 86% to 95% and a specificity of 81% to 98%. Skilled observers with at least one year of OCT-experience showed an overall higher diagnostic accuracy compared to inexperienced observers. The study shows an improved diagnostic accuracy of OCT in differentiating AK and BCC from healthy skin using state-of-the-art technology compared to earlier OCT technology, especially concerning BCC diagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

Fungi isolated from the skin lesions of Ghezel and Makui sheep with suspected ringworm in Urmia, Iran

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A Araghi – Sooreh

2012-05-01

Full Text Available Non-dermatophytic fungi are frequently isolated on the cultures used in surveys of animals suspected of having ringworm. The present study was conducted to identify of saprophytic fungi and dermatophyte isolated from sheep with suspected ringworm in Urmia, Iran. A total of 1323 sheep from two breeds of Ghezel (n = 727 and Makui (n = 596 were examined for skin lesions. Only 4(0.035 % lesions with hair loss and scaling were found on ears of Ghezel sheep. Samples were examined microscopically by KOH and cultured ontoSabouraud’s dextrose agar and Sabouraud’s dextrose with chloramphenicol and cycloheximide, incubated at 25 and 37 ° C and examined for 4weeks. All (100% of the specimens yielded positive culture. Fungal isolates were Alternariaspp. (3 cases, 75 % and Mucor spp. (2 cases, 50%. No dermatophyte fungi were cultured from suspected ringworm lesions. Saprophytic fungi isolated in the present study may not be considered as cause of skin lesions in Ghezel sheep.

Interventions for preventing and managing of skin lesions after radiation.

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Eleni Bafe

2017-12-01

Full Text Available Introduction: Radiotherapy has a pivotal role in the fight against cancer. However 85% of patients, who undergo radiotherapy, will face moderate to severe skin reactions, for the treatment of which various local products, available in the market, are used. Aim: The aim of this systematic literature review was to investigate the prevention and treatment of these skin lesions induced by radiation. Methods: For this purpose 34 articles were collected concerning materials, approved by the FDA, for the prevention and treatment of skin damage due to radiation, preclinical factors tested in animal models, factors involved in the prevention and treatment of moist desquamation and unauthorized agents or with little information about them. Results: According to the study results, the moisturizing and hydrophilic creams, herbal preparations, gels based on hyaluronic acid, and Vitamin E, heparinoid creams and formulations based on oils appear to have a positive effect in preventing dermatitis as well as in providing symptom relief. Patches are suitable for the case of moist desquamation. Vasculotide, agent EUK-207, agent RTA 408, agent ALDH2 and the agent Celecoxib are still in the preclinical stage but may become future therapeutic targets. Conclusion: Skin reactions due to radiation remain a significant problem for patients undergoing radical treatment. However, thanks to the multitude of formulations available in the market and several clinical trials it is possible that early prevention and treatment for actinic dermatitis could be achieved. In conclusion, it is crucial that health professionals are aware of the formulations indicated and contraindicated in case of skin reactions induced by radiation and adjust the treatment for the prevention and management of skin reactions in patients receiving radiation therapy.

Prevalence of skin lesions and need for treatment in a cohort of 90 880 workers.

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Augustin, M; Herberger, K; Hintzen, S; Heigel, H; Franzke, N; Schäfer, I

2011-10-01

Healthcare planning requires robust data on the prevalence and need for care of dermatological diseases. To date, no systematic data in population-based samples are available for Germany. Determination of the prevalence of skin lesions and of the need for care based on dermatological examinations in working adults in Germany. From 2004 to 2009, workers aged between 16 and 70years from different branches of industry throughout Germany underwent a single dermatological whole-body examination on the occasion of company screening for skin cancer. The data were recorded electronically and evaluated descriptively. In addition to the clinical findings, case history data on previous skin diseases were documented and the need for further clarification or treatment was determined on the basis of the dermatologist's assessment. Data from n=90 880 persons from a total of 312 companies were evaluated. Of the pigmented skin lesions, dermal naevi were found in 25·1% of the cohort, and 16·7% displayed more than 40 each. The most frequent inflammatory skin diseases were acne vulgaris (3·9%), psoriasis (2·0%), rosacea (2·3%) and atopic eczema (1·3%). Examination of the case histories showed that the most frequent condition was allergic sensitizations (41·1%); of these, pollen accounted for the biggest group (21·4%), followed by contact allergens (8·0%). In total, 26·8% of the cohort exhibited a dermatological finding in need of treatment or further clarification. Dermatological lesions and diseases requiring clarification are frequent and indicate a high demand for treatment in the adult population. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

First identification of the herpes simplex virus by skin-dedicated ex vivo fluorescence confocal microscopy during herpetic skin infections.

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Cinotti, E; Perrot, J L; Labeille, B; Campolmi, N; Thuret, G; Naigeon, N; Bourlet, T; Pillet, S; Cambazard, F

2015-06-01

Skin-dedicated ex vivo fluorescence confocal microscopy (FCM) has so far been used to identify cutaneous tumours on freshly excised samples using acridine orange as fluorochrome. To use FCM for a new indication, namely, the identification of the herpes simplex virus (HSV) in skin lesions, using fluorescent antibodies. Six roof samples from skin vesicles suspicious for HSV lesions were incubated with anti-HSV-1 and anti-HSV-2 antibodies coupled with fluorescein isothiocyanate, and examined under skin-dedicated ex vivo FCM. The positive controls were swabs taken from the floor of each vesicle and observed under conventional direct fluorescence assay (DFA) and by viral cultures. Roof samples from three bullae of bullous pemphigoid were the negative controls. Using ex vivo FCM, the samples from the lesions clinically suspicious for HSV infection were seen to be fluorescent after incubation with anti-HSV-1, and were negative after incubation with anti-HSV-2 antibodies. Conventional DFA with an optical microscope and cultures confirmed the presence of HSV-1 infection. By using fluorescent antibodies to identify precise structures, ex vivo FCM can be used for indications other than tumour identification. More specifically, it can be an additional diagnostic tool for HSV infection. © 2014 British Association of Dermatologists.

Comparative diagnostic performance of multidetector computed tomography and MRI for characterization of pancreatic cystic lesions

International Nuclear Information System (INIS)

Moon, Sung Min; Shin, Sang Soo; Park, Jin Gyoon; Jeong, Yong Yeon

2015-01-01

To compare the diagnostic performance of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in characterization of pancreatic cystic lesions. We conducted a retrospective study on 34 patients with histopathologically proven cystic pancreatic lesions who underwent both preoperative MDCT and MRI. CT and MRI were independently evaluated for differentiating mucinous vs. non-mucinous lesions, differentiating aggressive vs. non-aggressive lesion, analyzing morphological features, and evaluating specific leading diagnoses. Sensitivity, specificity, and accuracy were determined. Competency assessment of lesional morphology analysis was performed using the kappa values of the 2 tests. The sensitivity, specificity, and accuracy of MRI for differentiating mucinous vs. non-mucinous lesions were higher than CT (p = 0.03). For differentiating aggressiveness, the sensitivity of MRI was better than CT, but the specificity of CT was better than MRI. In evaluation of morphologic features, MRI showed better performance in characterization of septa and wall. Otherwise, the 2 modalities showed similarly good performance. MRI was better than CT in determining a specific diagnosis (58.8% vs. 47.2%, respectively). CT and MRI are reasonable diagnostic methods for characterization of pancreatic cystic lesions. However, MRI enables more confident assessment than CT in differentiating mucinous vs. non-mucinous lesions and characterization of the septa and wall

Calciphylaxis: Temporal Artery Calcification Preceding Widespread Skin Lesions and Penile Necrosis

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Manzoor A. Shah

2012-01-01

Full Text Available Temporal artery calciphylaxis has rarely been described in chronic kidney disease patients on dialysis. We report a case of 72-year-old Caucasian man with multiple comorbidities and end-stage renal disease on dialysis who presented with temporal artery calcification leading to bilateral loss of vision followed by extensive skin lesions including one on glans penis. While on peritoneal dialysis, he developed anterior ischemic optic neuropathy, had no improvement on high dose steroids, and temporal artery biopsy showed marked calcification without any evidence of vasculitis. Few weeks later on hemodialysis, he developed widespread cutaneous lesions on extremities and penile necrosis with skin biopsy revealing calciphylaxis. On literature review of calciphylaxis in chronic kidney disease, we found only four cases of temporal artery calciphylaxis leading to anterior ischemic optic neuropathy and blindness. We believe this is the first case in which the rare temporal artery calciphylaxis and the uncommon penile necrosis are being described together. The objective is to emphasize the need to recognize this condition early in the CKD patients on dialysis presenting with visual symptoms as the different treatment strategies may help prevent complete loss of vision and also modify or prevent a full blown calciphylaxis.

The diagnostic value of CT bronchial sign in peripheral solitary pulmonary lesions

International Nuclear Information System (INIS)

Sun Pengfei; Xiao Xiangsheng; Liu Shiyuan; Yu Hong; Li Huimin

2008-01-01

Objective: To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions (SPLs). Methods: One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT (MSCT), and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus, the differences between the benign and malignancy were compared by using chi-square test. Results: Bronchial cutoff rate in malignant lesions (47/95, 49.5%) was markedly higher than that in benign lesions (10/42,23.8%. χ 2 =7.896, P 2 =6.975,4.818, P 2 =7.390,P 2 =0.641,0.062, P>0.05). The focal bronchial wall thickening in malignancy (21/22) was markedly higher than benign lesions (1/22. χ 2 =4.185, P 2 =8.650, P<0.05). Conclusion: CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions. (authors)

Development and psychometric testing of the 'Motivation and Self-Efficacy in Early Detection of Skin Lesions' index.

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Dyson, Judith; Cowdell, Fiona

2014-12-01

To develop and psychometrically test the Motivation and Self-Efficacy in Early Detection of Skin Lesions Index. Skin cancer is the most frequently diagnosed cancer worldwide. The primary strategy used to prevent skin cancer is promotion of sun avoidance and the use of sun protection. However, despite costly and extensive campaigns, cases of skin cancer continue to increase. If found and treated early, skin cancer is curable. Early detection is, therefore, very important. The study was conducted in 2013. Instrument Development. A literature review and a survey identified barriers (factors that hinder) and levers (factors that help) to skin self-examination. These were categorized according to a the Theoretical Domains Framework and this formed the basis of an instrument, which was tested for validity and reliability using confirmatory factor analysis and Cronbach's alpha respectively. A five-factor 20-item instrument was used that tested well for reliability and construct validity. Test-retest reliability was good for all items and domains. The five factors were: (i) Outcome expectancies; (ii) Intention; (iii) Self-efficacy; (iv) Social influences; (v) Memory. The Motivation and Self-Efficacy in Early Detection of Skin Lesions Index provides a reliable and valid method of assessing barriers and levers to skin self-examination. The next step is to design a theory-based intervention that can be tailored according to individual determinants to behaviour change identified by this instrument. © 2014 John Wiley & Sons Ltd.

Skin lesions diagnostics by on diffuse reflection spectres using computational algorithms: a preliminary study

International Nuclear Information System (INIS)

Orozco-Guillen, E.E.; Delgado-Atencio, J.A.; Vazquez-Montiel, S.; Castro-Ramos, J.; Villanueva-Luna, E.; Gutierrez-Delgado, F.

2009-01-01

The determination of diffuse reflection spectrum on human skin in the spectral range from 400nm-1000nm using an optical fiber spectrometers is a non-invasive technique widely used to study the optical parameters of this tissue, provides information about the absorption and scattering properties of light that can be employed to study the morphology and physiology of the tissue and to detect and diagnose skin diseases in early stages. In this paper a computational algorithm for the selection of the most important attributes of diffuse reflection spectra of human skin obtained with an experimental system that basically consists of a spectrometer, a white light source and bifurcated fiber optic probe that allows send and collect light. To classify the spectral signal was designed a Matlab2006 graphical interface which use support vector machines and algorithm for selecting attributes that allows to achieve a sensitivity and specificity exceeding 80% and 85% of accuracy in the classification. (Author)

Chronic myelomonocytic leukemia masquerading as cutaneous indeterminate dendritic cell tumor: Expanding the spectrum of skin lesions in chronic myelomonocytic leukemia.

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Loghavi, Sanam; Curry, Jonathan L; Garcia-Manero, Guillermo; Patel, Keyur P; Xu, Jie; Khoury, Joseph D; Torres-Cabala, Carlos A; Nagarajan, Priyadharsini; Aung, Phyu P; Gibson, Bernard R; Goodwin, Brandon P; Kelly, Brent C; Korivi, Brinda R; Medeiros, L Jeffrey; Prieto, Victor G; Kantarjian, Hagop M; Bueso-Ramos, Carlos E; Tetzlaff, Michael T

2017-12-01

Chronic myelomonocytic leukemia (CMML) is a hematopoietic stem cell neoplasm exhibiting both myelodysplastic and myeloproliferative features. Cutaneous involvement by CMML is critical to recognize as it typically is a harbinger of disease progression and an increased incidence of transformation to acute myeloid leukemia. Cutaneous lesions of CMML exhibit heterogeneous histopathologic features that can be challenging to recognize as CMML. We describe a 67-year-old man with a 3-year history of CMML who had been managed on single-agent azacitidine with stable disease before developing splenomegaly and acute onset skin lesions. Examination of these skin lesions revealed a dense infiltrate of histiocytic cells morphologically resembling Langerhans type cells (lacking frank histopathologic atypia), and with the immunophenotype of an indeterminate cell histiocytosis (S100+ CD1a+ and langerin-). Given the history of CMML, next-generation sequencing studies were performed on the skin biopsy. These revealed a KRAS (p.G12R) mutation identical to that seen in the CMML 3 years prior, establishing a clonal relationship between the 2 processes. This case expands the spectrum for and underscores the protean nature of cutaneous involvement by CMML and underscores the importance of heightened vigilance when evaluating skin lesions of CMML patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Diagnostic Performance and Confidence of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Cystic and Cysticlike Liver Lesions.

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Corvino, Antonio; Catalano, Orlando; Corvino, Fabio; Sandomenico, Fabio; Petrillo, Antonella

2017-09-01

The aims of this study were to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the characterization of atypical cystic and cysticlike focal liver lesions in comparison with conventional US and to determine whether the use of CEUS can reduce the need for further diagnostic workup. In a 3-year period 48 patients with 50 atypical cystic and cysticlike lesions found at conventional US underwent CEUS. Diagnostic confirmation was obtained in cytohistopathologic examinations, with other imaging modalities, and in follow-up. Overall, there were 24 cystic lesions and 26 cysticlike solid lesions, specifically 32 benign and 18 malignant lesions. The conventional US and CEUS images and cine loops were reviewed by two blinded readers independently. Sensitivity, specificity, area under the ROC curve (A z ), and interobserver agreement were calculated. Diagnostic performance improved after review of CEUS examinations by both readers (conventional US A z = 0.781 vs 0.972; CEUS A z = 0.734 vs 0.957). Interreader agreement increased, although slightly (conventional US weighted κ = 0.894; CEUS weighted κ = 0.953). In terms of differential diagnosis, the occurrence of correctly characterized lesions increased after CEUS for both readers (reader 1, 62% to 98%; reader 2, 56% to 96%). The development of low-acoustic-power CEUS has made it possible to identify several imaging features of cystic and cysticlike focal liver lesions that, in association with history and clinical findings, may help to correctly characterize them. Our data indicate the usefulness of CEUS in the evaluation of patients with these lesions.

Evaluation of selenium in biological sample of arsenic exposed female skin lesions and skin cancer patients with related to non-exposed skin cancer patients

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Kolachi, Nida F.; Kazi, Tasneem G., E-mail: tgkazi@yahoo.com; Wadhwa, Sham K.; Afridi, Hassan I.; Baig, Jameel A.; Khan, Sumaira; Shah, Faheem

2011-08-01

The antagonistic effects between selenium (Se) and arsenic (As) suggest that low Se status plays an important role in arsenism development. The objective of present study was to assess Se contents in biological samples of As exposed females have skin lesions and cancer with related to non-exposed skin cancer patients. The biological samples (blood and scalp hair) of As exposed group comprises, female skin cancer (ESC) patients admitted in cancer hospitals have skin lesions (ESL) and exposed referents have not both diseases (ER), belongs to As exposed area of Pakistan. For comparative purposes, age matched female skin cancerous patient (RP) and non-cancerous females (NER) belong to non-exposed areas were also selected. The As and Se in acid digests of biological samples were pre-concentrated by complexing with chelating agent (ammonium pyrrolidinedithiocarbamate), and resulted complexes were extracted into non-ionic extractant (Triton X-114), prior to analysis by electrothermal atomic absorption spectrometry. The enhancement factor of about 25 was obtained by pre-concentrating 10 mL of sample solutions. The accuracy of the optimized procedure was evaluated by using certified reference material (BCR 397) with certified values for Se and As and standard addition method at three concentration levels in real samples. No significant differences was observed (p > 0.05) when comparing the values obtained by the proposed method, added and certified values of both elements. The biological samples of ESC patients had 2-3 folds higher As and lower Se levels as compared to RP (p < 0.001). Understudied exposed referents have high level of As and lower Se contents as compared to referents subjects of non-exposed area (p < 0.01). The higher concentration of As and lower levels of Se in biological samples of cancerous patients are consisted with reported studies. - Research Highlights: {yields} Advance extraction method for the enrichment of arsenic and selenium in biological

Evaluation of selenium in biological sample of arsenic exposed female skin lesions and skin cancer patients with related to non-exposed skin cancer patients

International Nuclear Information System (INIS)

Kolachi, Nida F.; Kazi, Tasneem G.; Wadhwa, Sham K.; Afridi, Hassan I.; Baig, Jameel A.; Khan, Sumaira; Shah, Faheem

2011-01-01

The antagonistic effects between selenium (Se) and arsenic (As) suggest that low Se status plays an important role in arsenism development. The objective of present study was to assess Se contents in biological samples of As exposed females have skin lesions and cancer with related to non-exposed skin cancer patients. The biological samples (blood and scalp hair) of As exposed group comprises, female skin cancer (ESC) patients admitted in cancer hospitals have skin lesions (ESL) and exposed referents have not both diseases (ER), belongs to As exposed area of Pakistan. For comparative purposes, age matched female skin cancerous patient (RP) and non-cancerous females (NER) belong to non-exposed areas were also selected. The As and Se in acid digests of biological samples were pre-concentrated by complexing with chelating agent (ammonium pyrrolidinedithiocarbamate), and resulted complexes were extracted into non-ionic extractant (Triton X-114), prior to analysis by electrothermal atomic absorption spectrometry. The enhancement factor of about 25 was obtained by pre-concentrating 10 mL of sample solutions. The accuracy of the optimized procedure was evaluated by using certified reference material (BCR 397) with certified values for Se and As and standard addition method at three concentration levels in real samples. No significant differences was observed (p > 0.05) when comparing the values obtained by the proposed method, added and certified values of both elements. The biological samples of ESC patients had 2-3 folds higher As and lower Se levels as compared to RP (p < 0.001). Understudied exposed referents have high level of As and lower Se contents as compared to referents subjects of non-exposed area (p < 0.01). The higher concentration of As and lower levels of Se in biological samples of cancerous patients are consisted with reported studies. - Research Highlights: → Advance extraction method for the enrichment of arsenic and selenium in biological matrices

Nonlethal screening of bat-wing skin with the use of ultraviolet fluorescence to detect lesions indicative of white-nose syndrome.

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Turner, Gregory G; Meteyer, Carol Uphoff; Barton, Hazel; Gumbs, John F; Reeder, DeeAnn M; Overton, Barrie; Bandouchova, Hana; Bartonička, Tomáš; Martínková, Natália; Pikula, Jiri; Zukal, Jan; Blehert, David S

2014-07-01

Definitive diagnosis of the bat disease white-nose syndrome (WNS) requires histologic analysis to identify the cutaneous erosions caused by the fungal pathogen Pseudogymnoascus [formerly Geomyces] destructans (Pd). Gross visual inspection does not distinguish bats with or without WNS, and no nonlethal, on-site, preliminary screening methods are available for WNS in bats. We demonstrate that long-wave ultraviolet (UV) light (wavelength 366-385 nm) elicits a distinct orange-yellow fluorescence in bat-wing membranes (skin) that corresponds directly with the fungal cupping erosions in histologic sections of skin that are the current gold standard for diagnosis of WNS. Between March 2009 and April 2012, wing membranes from 168 North American bat carcasses submitted to the US Geological Survey National Wildlife Health Center were examined with the use of both UV light and histology. Comparison of these techniques showed that 98.8% of the bats with foci of orange-yellow wing fluorescence (n=80) were WNS-positive based on histologic diagnosis; bat wings that did not fluoresce under UV light (n=88) were all histologically negative for WNS lesions. Punch biopsy samples as small as 3 mm taken from areas of wing with UV fluorescence were effective for identifying lesions diagnostic for WNS by histopathology. In a nonlethal biopsy-based study of 62 bats sampled (4-mm diameter) in hibernacula of the Czech Republic during 2012, 95.5% of fluorescent (n=22) and 100% of nonfluorescent (n=40) wing samples were confirmed by histopathology to be WNS positive and negative, respectively. This evidence supports use of long-wave UV light as a nonlethal and field-applicable method to screen bats for lesions indicative of WNS. Further, UV fluorescence can be used to guide targeted, nonlethal biopsy sampling for follow-up molecular testing, fungal culture analysis, and histologic confirmation of WNS.

Nonlethal screening of bat-wing skin with the use of ultraviolet fluorescence to detect lesions indicative of white-nose syndrome

Science.gov (United States)

Turner, Gregory G.; Meteyer, Carol U.; Barton, Hazel; Gumbs, John F.; Reeder, DeeAnn M.; Overton, Barrie; Bandouchova, Hana; Bartonička, Tomáš; Martínková, Natália; Pikula, Jiri; Zukal, Jan; Blehert, David S.

2014-01-01

Definitive diagnosis of the bat disease white-nose syndrome (WNS) requires histologic analysis to identify the cutaneous erosions caused by the fungal pathogen Pseudogymnoascus [formerly Geomyces] destructans (Pd). Gross visual inspection does not distinguish bats with or without WNS, and no nonlethal, on-site, preliminary screening methods are available for WNS in bats. We demonstrate that long-wave ultraviolet (UV) light (wavelength 368–385 nm) elicits a distinct orange–yellow fluorescence in bat-wing membranes (skin) that corresponds directly with the fungal cupping erosions in histologic sections of skin that are the current gold standard for diagnosis of WNS. Between March 2009 and April 2012, wing membranes from 168 North American bat carcasses submitted to the U.S. Geological Survey National Wildlife Health Center were examined with the use of both UV light and histology. Comparison of these techniques showed that 98.8% of the bats with foci of orange–yellow wing fluorescence (n = 80) were WNS-positive based on histologic diagnosis; bat wings that did not fluoresce under UV light (n = 88) were all histologically negative for WNS lesions. Punch biopsy samples as small as 3 mm taken from areas of wing with UV fluorescence were effective for identifying lesions diagnostic for WNS by histopathology. In a nonlethal biopsy-based study of 62 bats sampled (4-mm diameter) in hibernacula of the Czech Republic during 2012, 95.5% of fluorescent (n = 22) and 100% of nonfluorescent (n = 40) wing samples were confirmed by histopathology to be WNS positive and negative, respectively. This evidence supports use of long-wave UV light as a nonlethal and field-applicable method to screen bats for lesions indicative of WNS. Further, UV fluorescence can be used to guide targeted, nonlethal biopsy sampling for follow-up molecular testing, fungal culture analysis, and histologic confirmation of WNS.

FISH analysis for diagnostic evaluation of challenging melanocytic lesions.

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Zimmermann, A K; Hirschmann, A; Pfeiffer, D; Paredes, B E; Diebold, J

2010-09-01

The differential diagnosis of malignant melanomas and atypical melanocytic nevi is still a diagnostic challenge. The currently accepted morphologic criteria show substantial interobserver variability, likewise immunohistochemical studies are often not able to discriminate these lesions reliably. Techniques that support diagnostic accuracy are of the greatest importance considering the growing incidence of malignant melanomas and their increase in younger patients. In this study we analyzed the feasibility of fluorescence in situ hybridization (FISH) analysis for the discrimination of malignant and benign melanocytic tumors. A panel of DNA probes was used to detect chromosomal aberrations of chromosomes 6 and 11. On a series of 5 clearly malignant and benign melanocytic tumors we confirmed the applicability of the test. Then we focused on examination of ambiguous melanocytic lesions, where atypical cells are often difficult to relocalize in the 4',6-Diamidino-2-phenylindol (DAPI)-fluorescence stain. FISH analyses were conducted on destained H&E-stained slides. By comparison of the DAPI-image with photos taken from the H&E stain, unambiguous assignment of the FISH results to the conspicuous groups of cells was possible. The results of FISH analysis were consistent with the conventional diagnosis in 11 of 14 small ambiguous lesions. Of the remaining 3 cases, 2 showed FISH-results close to the cut-off level. Comparison of FISH results on thin and thick sections revealed that the cut-off values have to be adapted for 2 microm destained sections. In conclusion, FISH analysis is a useful and applicable tool for assessment of even smallest melanocytic neoplasms, although there will remain unclear cases that cannot be solved even after additional FISH evaluation.

Molecular detection of avian pox virus from nodular skin and mucosal fibrinonecrotic lesions of Iranian backyard poultry.

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Gholami-Ahangaran, Majid; Zia-Jahromi, Noosha; Namjoo, Abdolrasul

2014-02-01

In recent years, some outbreaks of skin lesions suspected to be avian pox were observed in the backyard poultry in different parts of western areas in Iran. Consequently, 328 backyard poultries with suspected signs of avian pox virus infection were sampled. All birds showed nodular lesions on unfeathered head skin and/or fibronecrotic lesions on mucus membrane of the oral cavity and upper respiratory tract. For histopathological analysis, the sections of tissue samples from cutaneous lesions of examined birds were stained with H&E method. For PCR, after DNA extraction a 578-bp fragment of avian pox virus from 4b core protein gene was amplified. Results showed 217 and 265 out of 328 (66.1 and 80.7%, respectively) samples were positive for avian pox virus on histopathological and PCR examination, respectively. In this study, the samples that had intracytoplasmic inclusion bodies on pathologic examination were PCR positive. This study revealed that PCR is a valuable tool for identification of an avian pox virus and that the frequency of pox infection in backyard poultry in western areas of Iran is high.

Aerobic bacteria and fungi from skin lesions of fish in Khartoum state

Directory of Open Access Journals (Sweden)

Walaa Hassan Ibrahim

2016-12-01

Conclusion: Fishes with skin lesions are harboring many pathogenic bacteria and fungi and may act as a source of zoonotic infections and can transmit several pathogens to workers in fish industry and consumers. Therefore, thorough and strict routine inspection of fish is recommended to ensure safety and that there are no serious risks to consumers. [J Adv Vet Anim Res 2016; 3(4.000: 375-385

Diagnostic value of coustic radiation force impulse for BI-RADS category 4 breast lesions of different sizes.

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Wu, Rong

2018-04-14

To determine the diagnostic value of combined conventional ultrasound (US) and acoustic radiation force impulse (ARFI) imaging for the differential diagnosis of BI-RADS category 4 breast lesions of different sizes. From April 2013 to January 2015, 283 patients (with a total of 292 breast lesions) who underwent US and ARFI examination were included in this retrospective study. The SWV for the lesion and adjacent normal breast tissue were measured and the SWV ratio was calculated. VTI grade was also assessed. The lesions were separated into three groups on the basis of size, and two combinations of ARFI parameters (SWV + VTI and SWV ratio + VTI) were applied to reassess the BI-RADS categories. Diagnoses were confirmed by pathological examination after biopsy or surgery. ROC analysis was performed to assess the diagnostic efficiency of each method. The Z test was used to compare the difference between AUC of the two methods. Significant improvement was seen in the diagnostic performance of US with the use of the ARFI parameters SWV + VTI (77/179 [43.0%] of BI-RADS category 4A breast lesions were downgraded) and SWV ratio + VTI (64/179 [35.8%] of BI-RADS category 4A breast lesions were downgraded, including two malignant cases that were misdiagnosed as benign) (P BI-RADS category 4 breast lesions. The combination of SWV ratio + VTI can improve BI-RADS classification of small lesions (<10 mm size).

Large Morel-Lavallée lesion presenting as fungating mass with skin ulceration.

Science.gov (United States)

Ryan, Christine E; Wachtel, Sarah; Leef, George; Ozdalga, Errol

2016-01-01

A Morel-Lavallée lesion, a type of soft tissue degloving injury that has also been referred to as a chronic expanding hematoma, is a relatively rare condition that usually develops following traumatic injury. Here, we present a case of a 60-year-old male with a Morel-Lavallée lesion diagnosed over 5 years after a traumatic injury of the hip. He presented with a large fungating mass and overlying skin ulceration, which was highly suspicious for sarcoma. However, lack of other systemic findings and constitutional complaints, as well as negative imaging studies, did not support a diagnosis of malignancy. This information, combined with the history of remote trauma to the affected area, instead led us to suspect the alternative diagnosis of a Morel-Lavallée lesion. The diagnosis was later confirmed by pathology showing a chronic expanding hematoma. To our knowledge, a Morel-Lavallée lesion presenting as a fungating mass has not been previously described.

Diagnostic importance of 18F-FDG PET/CT parameters and total lesion glycolysis in differentiating between benign and malignant adrenal lesions.

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Ciftci, Esra; Turgut, Bulent; Cakmakcilar, Ali; Erturk, Seyit A

2017-09-01

Benign adrenal lesions are prevalent in oncologic imaging and make metastatic disease diagnoses difficult. This study evaluates the diagnostic importance of metabolic, volumetric, and metabolovolumetric parameters measured by fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT in differentiating between benign and malignant adrenal lesions in cancer patients. In this retrospective study, we evaluated F-FDG PET/CT parameters of adrenal lesions of follow-up cancer patients referred to our clinic between January 2012 and November 2016. The diagnosis of adrenal malignant lesions was made on the basis of interval growth or reduction after chemotherapy. Patient demographics, analysis of metabolic parameters such as maximum standard uptake value (SUVmax), tumor SUVmax/liver SUVmean ratio (T/LR), morphologic parameters such as size, Hounsfield Units, and computed tomography (CT) volume, and metabolovolumetric parameters such as metabolic tumor volume and total lesion glycolysis (TLG) of adrenal lesions were calculated. PET/CT parameters were assessed using the Mann-Whitney U-test and receiving operating characteristic analysis. In total, 186 adrenal lesions in 163 cancer patients (108 men/54 women; mean±SD age: 64±10.9 years) were subjected to F-FDG PET/CT for tumor evaluation. SUVmax values (mean±SD) were 2.8±0.8 and 10.6±6; TLG were 10.8±9.2 and 124.4±347.9; and T/LR were 1±0.3 and 4.1±2.6 in benign and malignant adrenal lesions, respectively. On the basis of the area under the curve, adrenal lesion SUVmax and T/LR had similar highest diagnostic performance for predicting malignant lesions (area under the curve: 0.993 and 0.991, respectively, P<0.001). Multivariate logistic regression analysis showed that T/LR, adrenal lesion SUVmax, and Hounsfield Units were independent predictive factors for malignancy rather than TLG. Irrespective of whether TLG was statistically highly significant for differentiating benign from malignant adrenal lesions, it did not reach the

The role of skin trauma in the distribution of morphea lesions: a cross-sectional survey of the Morphea in Adults and Children (MAC) cohort IV

Science.gov (United States)

Grabell, Daniel; Hsieh, Clifford; Andrew, Rachel; Martires, Kathryn; Kim, Andrew; Vasquez, Rebecca; Jacobe, Heidi

2014-01-01

Background Skin trauma may play a role in the development of morphea lesions. The association between trauma and the distribution of cutaneous lesions has never been examined. Objective Determine whether patients enrolled in the Morphea in Adults and Children (MAC) cohort exhibit skin lesions distributed in areas of prior (isotopic) or ongoing (isomorphic) trauma. Methods Cross-sectional analysis of the MAC cohort. Results Of 329 patients in the MAC cohort, 52 (16%) had trauma associated lesions at the onset of disease. Patients with lesions in an isotopic distribution had greater clinical severity as measured by a clinical outcome measure (mean modified Rodnan Skin Score of 13.8 vs. 5.3, P=0.004, 95% CI=3.08-13.92) and impact on life quality (mean Dermatology Life Quality Index 8.4 vs. 4.1, P=0.009, 95% CI 1.18-7.50) than those with an isomorphic distribution. Most frequent associated trauma were chronic friction (isomorphic) and surgery/isotopic. Limitations Recall bias for patient reported events. Conclusion Sixteen percent of patients in the MAC cohort developed initial morphea lesions at sites of skin trauma. If these findings can be confirmed in additional series, they suggest that elective procedures and excessive skin trauma or friction might be avoided in these patients. PMID:24880663

Laser induced autofluorescence for diagnosis of non-melanoma skin cancer

Science.gov (United States)

Drakaki, E.; Makropoulou, M.; Serafetinides, A. A.; Merlemis, N.; Kalatzis, I.; Sianoudis, I. A.; Batsi, O.; Christofidou, E.; Stratigos, A. J.; Katsambas, A. D.; Antoniou, Ch.

2015-01-01

Non melanoma skin cancer is one of the most frequent malignant tumors among humans. A non-invasive technique, with high sensitivity and high specificity, would be the most suitable method for basal cell carcinoma (BCC) or other malignancies diagnostics, instead of the well established biopsy and histopathology examination. In the last decades, a non-invasive, spectroscopic diagnostic method was introduced, the laser induced fluorescence (LIF), which could generate an image contrast between different states of skin tissue. The noninvasiveness consists in that this biophotonic method do not require tissue sample excision, what is necessary in histopathology characterization and biochemical analysis of the skin tissue samples, which is worldwide used as an evaluation gold standard. The object of this study is to establish the possibilities of a relatively portable system for laser induced skin autofluorescence to differentiate malignant from nonmalignant skin lesions. Unstained human skin samples, excised from humans undergoing biopsy examination, were irradiated with a Nd:YAG-3ω laser (λ=355 nm, 6 ns), used as an excitation source for the autofluorescence measurements. A portable fiber-based spectrometer was used to record fluorescence spectra of the sites of interest. The ex vivo results, obtained with this spectroscopic technique, were correlated with the histopathology results. After the analysis of the fluorescence spectra of almost 60 skin tissue areas, we developed an algorithm to distinguish different types of malignant lesions, including inflammatory areas. Optimization of the data analysis and potential use of LIF spectroscopy with 355 nm Nd:YAG laser excitation of tissue autofluorescence for clinical applications are discussed.

Elevated levels of plasma Big endothelin-1 and its relation to hypertension and skin lesions in individuals exposed to arsenic

International Nuclear Information System (INIS)

Hossain, Ekhtear; Islam, Khairul; Yeasmin, Fouzia; Karim, Md. Rezaul; Rahman, Mashiur; Agarwal, Smita; Hossain, Shakhawoat; Aziz, Abdul; Al Mamun, Abdullah; Sheikh, Afzal; Haque, Abedul; Hossain, M. Tofazzal; Hossain, Mostaque; Haris, Parvez I.; Ikemura, Noriaki; Inoue, Kiyoshi; Miyataka, Hideki; Himeno, Seiichiro; Hossain, Khaled

2012-01-01

Chronic arsenic (As) exposure affects the endothelial system causing several diseases. Big endothelin-1 (Big ET-1), the biological precursor of endothelin-1 (ET-1) is a more accurate indicator of the degree of activation of the endothelial system. Effect of As exposure on the plasma Big ET-1 levels and its physiological implications have not yet been documented. We evaluated plasma Big ET-1 levels and their relation to hypertension and skin lesions in As exposed individuals in Bangladesh. A total of 304 study subjects from the As-endemic and non-endemic areas in Bangladesh were recruited for this study. As concentrations in water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The plasma Big ET-1 levels were measured using a one-step sandwich enzyme immunoassay kit. Significant increase in Big ET-1 levels were observed with the increasing concentrations of As in drinking water, hair and nails. Further, before and after adjusting with different covariates, plasma Big ET-1 levels were found to be significantly associated with the water, hair and nail As concentrations of the study subjects. Big ET-1 levels were also higher in the higher exposure groups compared to the lowest (reference) group. Interestingly, we observed that Big ET-1 levels were significantly higher in the hypertensive and skin lesion groups compared to the normotensive and without skin lesion counterpart, respectively of the study subjects in As-endemic areas. Thus, this study demonstrated a novel dose–response relationship between As exposure and plasma Big ET-1 levels indicating the possible involvement of plasma Big ET-1 levels in As-induced hypertension and skin lesions. -- Highlights: ► Plasma Big ET-1 is an indicator of endothelial damage. ► Plasma Big ET-1 level increases dose-dependently in arsenic exposed individuals. ► Study subjects in arsenic-endemic areas with hypertension have elevated Big ET-1 levels. ► Study subjects with arsenic

Elevated levels of plasma Big endothelin-1 and its relation to hypertension and skin lesions in individuals exposed to arsenic

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Hossain, Ekhtear; Islam, Khairul; Yeasmin, Fouzia [Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205 (Bangladesh); Karim, Md. Rezaul [Department of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003 (Bangladesh); Rahman, Mashiur; Agarwal, Smita; Hossain, Shakhawoat; Aziz, Abdul; Al Mamun, Abdullah; Sheikh, Afzal; Haque, Abedul; Hossain, M. Tofazzal [Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205 (Bangladesh); Hossain, Mostaque [Department of Medicine, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka (Bangladesh); Haris, Parvez I. [Faculty of Health and Life Sciences, De Montfort University, Leicester, LE1 9BH (United Kingdom); Ikemura, Noriaki; Inoue, Kiyoshi; Miyataka, Hideki; Himeno, Seiichiro [Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770–8514 (Japan); Hossain, Khaled, E-mail: khossain69@yahoo.com [Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205 (Bangladesh)

2012-03-01

Chronic arsenic (As) exposure affects the endothelial system causing several diseases. Big endothelin-1 (Big ET-1), the biological precursor of endothelin-1 (ET-1) is a more accurate indicator of the degree of activation of the endothelial system. Effect of As exposure on the plasma Big ET-1 levels and its physiological implications have not yet been documented. We evaluated plasma Big ET-1 levels and their relation to hypertension and skin lesions in As exposed individuals in Bangladesh. A total of 304 study subjects from the As-endemic and non-endemic areas in Bangladesh were recruited for this study. As concentrations in water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The plasma Big ET-1 levels were measured using a one-step sandwich enzyme immunoassay kit. Significant increase in Big ET-1 levels were observed with the increasing concentrations of As in drinking water, hair and nails. Further, before and after adjusting with different covariates, plasma Big ET-1 levels were found to be significantly associated with the water, hair and nail As concentrations of the study subjects. Big ET-1 levels were also higher in the higher exposure groups compared to the lowest (reference) group. Interestingly, we observed that Big ET-1 levels were significantly higher in the hypertensive and skin lesion groups compared to the normotensive and without skin lesion counterpart, respectively of the study subjects in As-endemic areas. Thus, this study demonstrated a novel dose–response relationship between As exposure and plasma Big ET-1 levels indicating the possible involvement of plasma Big ET-1 levels in As-induced hypertension and skin lesions. -- Highlights: ► Plasma Big ET-1 is an indicator of endothelial damage. ► Plasma Big ET-1 level increases dose-dependently in arsenic exposed individuals. ► Study subjects in arsenic-endemic areas with hypertension have elevated Big ET-1 levels. ► Study subjects with arsenic

Clinical and diagnostic value of preoperative MR mammography and FDG-PET in suspicious breast lesions

International Nuclear Information System (INIS)

Walter, C.; Scheidhauer, K.; Theissen, P.; Scharl, A.; Goering, U.J.; Kugel, H.; Krahe, T.; Pietrzyk, U.

2003-01-01

Dynamic enhanced magnetic resonance (MR) mammography and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) of the breast were directly compared preoperatively in suspicious breast lesions. Forty-two breast lesions in 40 patients were examined with a three-dimensional dynamic MR imaging series and FDG-PET. The MR and PET examinations were evaluated separately and the results were compared with the histological findings. The sensitivity and specificity of each method were calculated. The diagnostic value of both modalities as single diagnostic tool and in combination was investigated. Nineteen malignant and 23 benign breast lesions were proven histologically. Magnetic resonance mammography and FDG-PET showed a sensitivity of 89 and 63%, respectively. The specificity was 74 and 91%, respectively. The combination of both imaging methods decreased the not-required biopsies from 55 to 17%. Only one false-negative finding - a patient pre-treated with chemotherapy - was observed in both methods. The combination of MR mammography and FDG-PET can help to decrease biopsies of benign breast lesions. Because of their high cost, these modalities should only be used in problematic cases to either rule out or to demonstrate malignancy. The best diagnostic strategy is achieved using MR mammography first. If the diagnosis is still questionable, FDG-PET can be performed. (orig.)

Arsenic-induced skin lesions among Atacameño people in Northern Chile despite good nutrition and centuries of exposure.

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Smith, A H; Arroyo, A P; Mazumder, D N; Kosnett, M J; Hernandez, A L; Beeris, M; Smith, M M; Moore, L E

2000-07-01

It has been suggested that the indigenous Atacameño people in Northern Chile might be protected from the health effects of arsenic in drinking water because of many centuries of exposure. Here we report on the first intensive investigation of arsenic-induced skin lesions in this population. We selected 11 families (44 participants) from the village of Chiu Chiu, which is supplied with water containing between 750 and 800 microg/L inorganic arsenic. For comparison, 8 families (31 participants) were also selected from a village where the water contains approximately 10 microg/L inorganic arsenic. After being transported to the nearest city for blind assessment, participants were examined by four physicians with experience in studying arsenic-induced lesions. Four of the six men from the exposed village, who had been drinking the contaminated water for more than 20 years, were diagnosed with skin lesions due to arsenic, but none of the women had definite lesions. A 13-year-old girl had definite skin pigmentation changes due to arsenic, and a 19-year-old boy had both pigmentation changes and keratoses on the palms of his hands and the soles of his feet. Family interviews identified a wide range of fruits and vegetables consumed daily by the affected participants, as well as the weekly intake of red meat and chicken. However, the prevalence of skin lesions among men and children in the small population studied was similar to that reported with corresponding arsenic drinking water concentrations in both Taiwan and West Bengal, India--populations in which extensive malnutrition has been thought to increase susceptibility.

Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

International Nuclear Information System (INIS)

Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens

2014-01-01

Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

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Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens, E-mail: macellomaciel@me.com [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

2014-09-15

Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

The use of tissue expander in repairing skin and hair lesions of the head

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Khatir A

1993-04-01

Full Text Available Of 14 cases who underwent this operation only in one of them because of infection in operation site, we had to extract the expander. Also, in the first day of the operation that we injected serum inside the expander of two other patients, the wound opened up and the expander appeared and came out automatically. The remaining ten patients have tolerated the operation after treatment period without any complications and good result was achieved. This method in covering up skin lesions and in eliminating burn as well as old wound scars was very effective and the patient become satisfied because there was no need to remove skin from other parts of the body and thus no new scars would have been created. The only problems in this method of treatment were its duration which is needed for injection inside the expander as well as bad appearance in operation region and these problems cause the patients to become depressed and to become isolated from the public for a long period. For the past three years that we used this method for covering skin lesions in different parts of the body and even in treating extensive spots and the hemantrium we achieved excellent results and the report will subsequently be submitted.

[Diagnostic capacity of skin prick test in egg and cow's milk allergic infants].

Science.gov (United States)

Yan, Jun-mei; Chen, Jing; Li, Hai-qi; Hu, Yan

2011-05-01

Mean diameter is the most common used parameter for wheal response assessment after skin prick test. This study aimed to investigate the diagnostic capacity of mean diameter according to the outcome of oral food challenge, and to determine the cut-off points that could render food challenges unnecessary. Data of 173 children referred to the Division of Primary Child Health Care for the evaluation of suspected food allergy were prospectively studied. All children underwent skin prick test and open food challenge to the relevant food(s) in clinic. The mean wheal diameter of skin prick test was measured, and open food challenge was performed to confirm food allergy. The SPSS software package version 13.0 for windows (SPSS, Chicago, IL, USA) was used for all statistical analysis. Open food challenge was taken as the gold standard for diagnosis. Diagnostic capacity of skin prick test, including the sensitivity, specificity, positive predictive value, negative predictive value, was calculated by cross-table. In addition, receiver operating characteristic curve (ROC) was plotted and area under the curve (AUC) was calculated to quantify the accuracy of the parameter. For the 173 children, 271 open food challenges were performed with egg white, egg yolk and cow's milk, In which 123 were positive, 99 children were diagnosed as food allergy. Cutaneous symptoms (87.0%) were most common, followed by gastrointestinal symptoms (9.8%). The AUC of mean diameter was 0.794 for egg white, 0.804 for egg yolk and 0.904 for cow's milk. The sensitivity of skin prick test with a cut-off value of ≥ 3 mm was ranged from 71% to 87%, while the specificity was between 31% and 57%. The authors also defined food specific skin prick test mean diameters that were 100% diagnostic for allergy to egg white (≥ 8.5 mm), egg yolk (≥ 5.5 mm), cow's milk (≥ 5.5 mm). Predictive decision points for a positive outcome of food challenges can be calculated for egg and cow's milk using mean diameter. It

In Situ complement activation and T-cell immunity in leprosy spectrum: An immunohistological study on leprosy lesional skin.

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Bahia El Idrissi, Nawal; Iyer, Anand M; Ramaglia, Valeria; Rosa, Patricia S; Soares, Cleverson T; Baas, Frank; Das, Pranab K

2017-01-01

Mycobacterium leprae (M. leprae) infection causes nerve damage and the condition worsens often during and long after treatment. Clearance of bacterial antigens including lipoarabinomannan (LAM) during and after treatment in leprosy patients is slow. We previously demonstrated that M. leprae LAM damages peripheral nerves by in situ generation of the membrane attack complex (MAC). Investigating the role of complement activation in skin lesions of leprosy patients might provide insight into the dynamics of in situ immune reactivity and the destructive pathology of M. leprae. In this study, we analyzed in skin lesions of leprosy patients, whether M. leprae antigen LAM deposition correlates with the deposition of complement activation products MAC and C3d on nerves and cells in the surrounding tissue. Skin biopsies of paucibacillary (n = 7), multibacillary leprosy patients (n = 7), and patients with erythema nodosum leprosum (ENL) (n = 6) or reversal reaction (RR) (n = 4) and controls (n = 5) were analyzed. The percentage of C3d, MAC and LAM deposition was significantly higher in the skin biopsies of multibacillary compared to paucibacillary patients (p = leprosy patients (r = 0.9578, pleprosy patients (p = leprosy patients, suggesting that inflammation driven by complement activation might contribute to nerve damage in the lesions of these patients. This should be regarded as an important factor in M. leprae nerve damage pathology.

Radiation injury of the skin following diagnostic and interventional fluoroscopic procedures

International Nuclear Information System (INIS)

Koenig, T.R.; Wagner, L.K.; Mettler, F.A.

2001-01-01

Many radiation injuries to the skin, resulting from diagnostic and interventional fluoroscopic procedures, have been reported in recent years. In some cases skin damage was severe and debilitating. We analyzed 72 reports of skin injuries for progression and location of injury, type and number of procedures, and contributing patient and operator factors. Most cases (46) were related to coronary angiography and percutaneous transluminal coronary angioplasty (PTCA). A smaller number was documented after cardiac radiofrequency catheter ablation (12), transjugular intrahepatic portosystemic shunt (TIPS) placement (7), neuroradiological interventions (3) and other procedures (4). Important factors leading to skin injuries were long exposure times over the same skin area, use of high dose rates, irradiation through thick tissue masses, hypersensitivity to radiation, and positioning of arms or breasts into the radiation entrance beam. Physicians were frequently unaware of the high radiation doses involved and did not recognize the injuries as radiation induced. Based on these findings, recommendations to reduce dose and improve patient care are provided. (author)

The role of skin trauma in the distribution of morphea lesions: a cross-sectional survey of the Morphea in Adults and Children cohort IV.

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Grabell, Daniel; Hsieh, Clifford; Andrew, Rachel; Martires, Kathryn; Kim, Andrew; Vasquez, Rebecca; Jacobe, Heidi

2014-09-01

Skin trauma may play a role in the development of morphea lesions. The association between trauma and the distribution of cutaneous lesions has never been examined to our knowledge. We sought to determine whether patients enrolled in the Morphea in Adults and Children (MAC) cohort exhibit skin lesions distributed in areas of prior (isotopic) or ongoing (isomorphic) trauma. This was a cross-sectional analysis of the MAC cohort. Of 329 patients in the MAC cohort, 52 (16%) had trauma-associated lesions at the onset of disease. Patients with lesions in an isotopic distribution had greater clinical severity as measured by a clinical outcome measure (mean modified Rodnan Skin Score of 13.8 vs 5.3, P = .004, 95% confidence interval 3.08-13.92) and impact on life quality (mean Dermatology Life Quality Index score 8.4 vs 4.1, P = .009, 95% confidence interval 1.18-7.50) than those with an isomorphic distribution. Most frequent associated traumas were chronic friction (isomorphic) and surgery/isotopic. Recall bias for patient-reported events is a limitation. Of patients in the MAC cohort, 16% developed initial morphea lesions at sites of skin trauma. If these findings can be confirmed in additional series, they suggest that elective procedures and excessive skin trauma or friction might be avoided in these patients. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Four Cases of Atopic Dermatitis Complicated by Sjogren's Syndrome: Link between Dry Skin and Autoimmune Anhidrosis

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Shun Kitaba

2011-01-01

Full Text Available We report four adult cases of atopic dermatitis (AD complicated by Sjogren's syndrome (SS. The patients fulfilled diagnostic criteria for AD and SS. All cases showed persistent itchy dry skin and eczematous lesions complicated by sicca symptoms including dry eyes and dry mouth with moderate joint pain. One case manifested annular erythema and another manifested widespread discoid erythema. To investigate the underlying cause of dry skin in these cases, sweating function was evaluated using a quantitative sudomotor axon reflex test (QSART in which the axon reflex is stimulated by acetylcholine iontophoresis. The sweating latency time was significantly prolonged in eczematous skin of AD and AD/SS compared to normal controls. Axon reflex (AXR sweat volume was also significantly reduced in AD (normal and eczematous skin and AD/SS (normal and eczema compared to normal control. In contrast, the direct sweat volume of lesional or non-lesional AD skin induced by direct stimulation with acetylcholine was only slightly reduced compared to that in normal controls, but not in SS and lesional skin of AD/SS patients. These results suggest that the impaired sweat response in AD is attributable to an abnormal sudomotor axon reflex, which is accelerated and modulated when complicated by SS resulting in dry skin in the present cases.

Risk factors for saddle-related skin lesions on elephants used in the tourism industry in Thailand.

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Magda, Scarlett; Spohn, Olivia; Angkawanish, Taweepoke; Smith, Dale A; Pearl, David L

2015-05-19

Lesions related to working conditions and improper saddle design are a concern for a variety of working animals including elephants. The objectives of the present study were to determine the prevalence of cutaneous lesions in anatomic regions (i.e., neck, girth, back, tail) in contact with saddle-related equipment among elephants in Thailand working in the tourism industry, and to identify potential risk factors associated with these lesions. Data for this cross-sectional study were collected between May 2007 and July 2007 on 194 elephants from 18 tourism camps across Thailand. There was a high prevalence (64.4 %; 95 % CI 57.3 - 71.2) of active lesions, most often located on the back region. Using multilevel multivariable logistic regression modelling containing a random intercept for camp we identified the following risk factors: increasing elephant age, the use of rice sacks as padding material in contact with the skin, and the provision of a break for the elephants. Working hours had a quadratic relationship with the log odds of an active lesion where the probability of an active lesion initially increased with the number of working hours per day and then declined possibly reflecting a "healthy worker" bias where only animals without lesions continue to be able to work these longer hours. While we recognize that the cross-sectional nature of the study posed some inferential limitations, our results offer several potential intervention points for the prevention of these lesions. Specifically, we recommend the following until longitudinal studies can be conducted: increased monitoring of older elephants and the back region of all elephants, working less than 6 hours per day, and the avoidance of rice sacks as padding material in contact with skin.

The role of UV induced lesions in skin carcinogenesis: an overview of oncogene and tumor suppressor gene modifications in xeroderma pigmentosum skin tumors

International Nuclear Information System (INIS)

Daya-Grosjean, Leela; Sarasin, Alain

2005-01-01

Xeroderma pigmentosum (XP), a rare hereditary syndrome, is characterized by a hypersensitivity to solar irradiation due to a defect in nucleotide excision repair resulting in a predisposition to squamous and basal cell carcinomas as well as malignant melanomas appearing at a very early age. The mutator phenotype of XP cells is evident by the higher levels of UV specific modifications found in key regulatory genes in XP skin tumors compared to those in the same tumor types from the normal population. Thus, XP provides a unique model for the study of unrepaired DNA lesions, mutations and skin carcinogenesis. The high level of ras oncogene activation, Ink4a-Arf and p53 tumor suppressor gene modifications as well as alterations of the different partners of the mitogenic sonic hedgehog signaling pathway (patched, smoothened and sonic hedgehog), characterized in XP skin tumors have clearly demonstrated the major role of the UV component of sunlight in the development of skin tumors. The majority of the mutations are C to T or tandem CC to TT UV signature transitions, occurring at bipyrimidine sequences, the specific targets of UV induced lesions. These characteristics are also found in the same genes modified in sporadic skin cancers but with lower frequencies confirming the validity of studying the XP model. The knowledge gained by studying XP tumors has given us a greater perception of the contribution of genetic predisposition to cancer as well as the consequences of the many alterations which modulate the activities of different genes affecting crucial pathways vital for maintaining cell homeostasis

The role of UV induced lesions in skin carcinogenesis: an overview of oncogene and tumor suppressor gene modifications in xeroderma pigmentosum skin tumors

Energy Technology Data Exchange (ETDEWEB)

Daya-Grosjean, Leela [Laboratory of Genetic Instability and Cancer, UPR2169 CNRS, IFR 54, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France)]. E-mail: daya@igr.fr; Sarasin, Alain [Laboratory of Genetic Instability and Cancer, UPR2169 CNRS, IFR 54, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France)

2005-04-01

Xeroderma pigmentosum (XP), a rare hereditary syndrome, is characterized by a hypersensitivity to solar irradiation due to a defect in nucleotide excision repair resulting in a predisposition to squamous and basal cell carcinomas as well as malignant melanomas appearing at a very early age. The mutator phenotype of XP cells is evident by the higher levels of UV specific modifications found in key regulatory genes in XP skin tumors compared to those in the same tumor types from the normal population. Thus, XP provides a unique model for the study of unrepaired DNA lesions, mutations and skin carcinogenesis. The high level of ras oncogene activation, Ink4a-Arf and p53 tumor suppressor gene modifications as well as alterations of the different partners of the mitogenic sonic hedgehog signaling pathway (patched, smoothened and sonic hedgehog), characterized in XP skin tumors have clearly demonstrated the major role of the UV component of sunlight in the development of skin tumors. The majority of the mutations are C to T or tandem CC to TT UV signature transitions, occurring at bipyrimidine sequences, the specific targets of UV induced lesions. These characteristics are also found in the same genes modified in sporadic skin cancers but with lower frequencies confirming the validity of studying the XP model. The knowledge gained by studying XP tumors has given us a greater perception of the contribution of genetic predisposition to cancer as well as the consequences of the many alterations which modulate the activities of different genes affecting crucial pathways vital for maintaining cell homeostasis.

How accurate are measurements of skin-lesion depths on prebiopsy supine chest computed tomography for transthoracic needle biopsies?

International Nuclear Information System (INIS)

Cheung, Joo Yeon; Kim, Yookyung; Shim, Sung Shine; Lee, Jin Hwa; Chang, Jung Hyun; Ryu, Yon Ju; Lee, Rena J.

2012-01-01

Aim: To evaluate the accuracy of depth measurements on supine chest computed tomography (CT) for transthoracic needle biopsy (TNB). Materials and methods: We measured skin-lesion depths from the skin surface to nodules on both prebiopsy supine CT scans and CT scans obtained during cone beam CT-guided TNB in the supine (n = 29) or prone (n = 40) position in 69 patients, and analyzed the differences between the two measurements, based on patient position for the biopsy and lesion location. Results: Skin-lesion depths measured on prebiopsy supine CT scans were significantly larger than those measured on CT scans obtained during TNB in the prone position (p < 0.001; mean difference ± standard deviation (SD), 6.2 ± 5.7 mm; range, 0–18 mm), but the differences showed marginal significance in the supine position (p = 0.051; 3.5 ± 3.9 mm; 0–13 mm). Additionally, the differences were significantly larger for the upper (mean ± SD, 7.8 ± 5.7 mm) and middle (10.1 ± 6.5 mm) lung zones than for the lower lung zones (3.1 ± 3.3 mm) in the prone position (p = 0.011), and were larger for the upper lung zone (4.6 ± 5.0 mm) than for the middle (2.4 ± 2.0 mm) and lower (2.3 ± 2.3 mm) lung zones in the supine position (p = 0.004). Conclusions: Skin-lesion depths measured on prebiopsy supine chest CT scans were inaccurate for TNB in the prone position, particularly for nodules in the upper and middle lung zones.

Herpes Zoster Lesions on Reconstructed Breast Skin: Rare Objective Proof of Reinervation

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Laurenz Weitgasser

2017-01-01

Full Text Available Blazed up Herpes zoster lesions have been described in very few patients after free and pedicled flap transfer for reconstructive purpose. Although sensory recovery after flap reconstructions has been studied extensively most studies addressed subjective perceptions of sensation. Objective investigations of spontaneous reinervation of free and pedicled flaps are rare. We would like to present a witnessed herpes zoster infection of a latissimus dorsi skin flap 2 years after breast reconstruction.

Diagnostic value of CD-10 marker in differentiating of papillary thyroid carcinoma from benign thyroid lesions

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Mojgan Mokhtari

2014-01-01

Full Text Available Background: Using of CD10 in accordance with clinical and histological features of thyroid lesions could be used as both diagnostic and prognostic tool, which consequently influence the management and their prognosis for survival of patients with thyroid neoplasms especially papillary thyroid carcinoma (PTC. The aim of this study was to determine its expression in PTC and different benign thyroid lesions. Materials and Methods: In this descriptive-analytic, cross-sectional study, paraffin-embedded tissues of patients with definitive pathologic diagnosis of different benign thyroid lesions and PTC were retrieved. Immunostained sections of each slides was performed using immunohistochemistry methods and expression of CD10 was compared in two groups of benign thyroid lesions and PTC. Results: From selected cases 134 sections studied in two groups of PTC (n = 67 and benign thyroid lesions (n = 67. CD10 were immunohistochemically positive in 29.9% of PTC cases, but in none of the thyroid benign lesions (0% (P 0.05. Conclusion: The results of the current study indicate that due to the higher expression of CD10 in PTC than benign thyroid lesions it might be used for differentiating mentioned lesions. But for using it as a diagnostic tool further studies with larger sample size and determination of its sensitivity, specificity and cut-off point is necessary.

Non-rinse skin cleansers: the way forward in preventing incontinence related moisture lesions?

Science.gov (United States)

Harries, F J; Begg, P A

2016-05-01

The use of non-rinse skin cleansers in the care of patients who are at risk of tissue breakdown is not new within the National Health Service (NHS). Back to the Floor Continence Care Rounds (introduced in 2012 to facilitate bedside continence care education) at University Hospitals Birmingham had identified that in the current climate of austerity and efficiency savings, the use of non-rinse cleanser was being randomly rationed. Our objective was to determine whether the introduction of a smaller tube of non-rinse cleanser with targeted education would improve usage and ultimately improve the skin of incontinent patients. There were five clinical areas randomised into two groups. In group 1 three clinical areas were provided with targeted education and new sizes of tubes of non-rinse skin cleanser. In group 2, the two remaining clinical areas acted as control groups, one receiving targeted education only and the remaining had no education or new sized tubes. The incidence of incontinence associated moisture lesions from each clinical area was monitored for 13 weeks pre and post study period. The in-depth study undertaken at University Hospitals Birmingham, over a 6-month period, confirmed a trend in staff committing to the ethos of prudency, and in turn compromising the use of the most effective treatment and prevention of incontinence associated moisture lesions. The ability of the Trust staff to recognise and respond to a change in practice and the responsiveness of a commercial provider to the proposed new methodology has resulted in a significant reduction in incontinence associated moisture lesions across the trust. The clinical areas included in the study demonstrated a 70-76.9% reduction in moisture lesion incidence compared to an 8.3-13.6% reduction in the control groups. The results strongly suggest that a reduction in incontinence associated moisture lesions can be achieved by a simple change in nursing regime. The combination of solid education provision

Distribución de las lesiones de la piel en la región de cabeza y cuello Distribution of skin lesions on the head and neck region

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TS Simão

Full Text Available El cáncer de piel (incluyendo el melanoma y los tipos de cáncer de piel de células basales y de células escamosas es por mucho, el tipo de cáncer más común de todos los cánceres. La mayoría de éstos son cánceres de células basales. Los cánceres de células escamosas ocurren con menos frecuencia. Noventa y seis por ciento de las resecciones de lesiones cutáneas, en la clínica de cirugía plástica del Hospital Servidor Público Estadual de Sao Paulo, están representadas por lesiones en las regiones de la cara, cabeza y cuello. El conocimiento del perfil epidemiológico del servicio, nos ayuda a establecer medidas de prevención y tratamiento de neoplasias cutáneas.Skin cancer (including melanoma and basal cell and squamous cell cancers is by far the most common type of cancer of all cancers. Most of these are basal cell cancers. Squamous cell cancers occur less frequently. Ninety-six percent of resections of skin lesions in the plastic surgery clinic of the Hospital Servidor Público Estadual de Sao Paulo, are represented by lesions in the regions of the face, head and neck. The knowledge of the epidemiological profile of service, helps us to establish prevention and treatment of skin malignancies.

Imaging inflammatory acne: lesion detection and tracking

Science.gov (United States)

Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

2010-02-01

It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

Intelligent Diagnostic Assistant for Complicated Skin Diseases through C5's Algorithm.

Science.gov (United States)

Jeddi, Fatemeh Rangraz; Arabfard, Masoud; Kermany, Zahra Arab

2017-09-01

Intelligent Diagnostic Assistant can be used for complicated diagnosis of skin diseases, which are among the most common causes of disability. The aim of this study was to design and implement a computerized intelligent diagnostic assistant for complicated skin diseases through C5's Algorithm. An applied-developmental study was done in 2015. Knowledge base was developed based on interviews with dermatologists through questionnaires and checklists. Knowledge representation was obtained from the train data in the database using Excel Microsoft Office. Clementine Software and C5's Algorithms were applied to draw the decision tree. Analysis of test accuracy was performed based on rules extracted using inference chains. The rules extracted from the decision tree were entered into the CLIPS programming environment and the intelligent diagnostic assistant was designed then. The rules were defined using forward chaining inference technique and were entered into Clips programming environment as RULE. The accuracy and error rates obtained in the training phase from the decision tree were 99.56% and 0.44%, respectively. The accuracy of the decision tree was 98% and the error was 2% in the test phase. Intelligent diagnostic assistant can be used as a reliable system with high accuracy, sensitivity, specificity, and agreement.

Modeling of skin cancer dermatoscopy images

Science.gov (United States)

Iralieva, Malica B.; Myakinin, Oleg O.; Bratchenko, Ivan A.; Zakharov, Valery P.

2018-04-01

An early identified cancer is more likely to effective respond to treatment and has a less expensive treatment as well. Dermatoscopy is one of general diagnostic techniques for skin cancer early detection that allows us in vivo evaluation of colors and microstructures on skin lesions. Digital phantoms with known properties are required during new instrument developing to compare sample's features with data from the instrument. An algorithm for image modeling of skin cancer is proposed in the paper. Steps of the algorithm include setting shape, texture generation, adding texture and normal skin background setting. The Gaussian represents the shape, and then the texture generation based on a fractal noise algorithm is responsible for spatial chromophores distributions, while the colormap applied to the values corresponds to spectral properties. Finally, a normal skin image simulated by mixed Monte Carlo method using a special online tool is added as a background. Varying of Asymmetry, Borders, Colors and Diameter settings is shown to be fully matched to the ABCD clinical recognition algorithm. The asymmetry is specified by setting different standard deviation values of Gaussian in different parts of image. The noise amplitude is increased to set the irregular borders score. Standard deviation is changed to determine size of the lesion. Colors are set by colormap changing. The algorithm for simulating different structural elements is required to match with others recognition algorithms.

The role of thymus-dependent T cells in hexachlorobenzene-induced inflammatory skin and lung lesions

NARCIS (Netherlands)

Michielsen, CCPPC; Bloksma, N; Klatter, FA; Rozing, J; Vos, JG; van Dijk, JE

1999-01-01

The involvement of thymus-dependent T cells in the inflammatory skin and lung lesions and spleen effects induced by hexachlorobenzene (HCB) was investigated by using genetically athymic and euthymic WAG/Rij rats and Brown Norway (BN) rats with or without depletion of T cells by adult thymectomy,

Acral melanocytic lesions in the United States: Prevalence, awareness, and dermoscopic patterns in skin-of-color and non-Hispanic white patients.

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Madankumar, Reshmi; Gumaste, Priyanka V; Martires, Kathryn; Schaffer, Panta R; Choudhary, Sonal; Falto-Aizpurua, Leyre; Arora, Harleen; Kallis, Penelope J; Patel, Shailee; Damanpour, Shadi; Sanchez, Margaret I; Yin, Natalie; Chan, Aegean; Sanchez, Miguel; Polsky, David; Kanavy, Holly; Grichnik, James M; Stein, Jennifer A

2016-04-01

Acral lentiginous melanoma has increased mortality compared with other melanoma subtypes and disproportionately affects ethnic minorities. Acral melanocytic lesions have not been well studied in diverse populations of the United States. We sought to assess the prevalence, awareness, and dermoscopic patterns of acral melanocytic lesions in skin-of-color and non-Hispanic white patients. We prospectively examined the palms and soles of 1052 patients presenting to dermatology clinics in New York, NY, and Miami, FL, from October 2013 to April 2015. Acral melanocytic lesions were observed in 36% of our cohort. Skin-of-color patients were more likely to have acral melanocytic lesions than non-Hispanic white patients (P < .01). Acral melanocytic lesions correlated with increased mole counts, particularly on non-Hispanic white patients. The majority of lesions demonstrated benign dermoscopic patterns. We observed 2 lesions with the parallel ridge pattern in our cohort, both found to be atypical nevi on biopsy specimen. Patients often lacked awareness of the presence of their lesions. Interobserver variability in assessing dermoscopic patterns is a limitation. Melanocytic lesions of the palms and soles are common, particularly in a cohort of multiple ethnicities from the United States. Dermoscopy of acral lesions is an important clinical tool for diagnosis and management of these lesions. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Oxidative DNA damage of peripheral blood polymorphonuclear leukocytes, selectively induced by chronic arsenic exposure, is associated with extent of arsenic-related skin lesions

International Nuclear Information System (INIS)

Pei, Qiuling; Ma, Ning; Zhang, Jing; Xu, Wenchao; Li, Yong; Ma, Zhifeng; Li, Yunyun; Tian, Fengjie; Zhang, Wenping; Mu, Jinjun; Li, Yuanfei; Wang, Dongxing; Liu, Haifang; Yang, Mimi; Ma, Caifeng; Yun, Fen

2013-01-01

There is increasing evidence that oxidative stress is an important risk factor for arsenic-related diseases. Peripheral blood leukocytes constitute an important defense against microorganisms or pathogens, while the research on the impact of chronic arsenic exposure on peripheral blood leukocytes is much more limited, especially at low level arsenic exposure. The purpose of the present study was to explore whether chronic arsenic exposure affects oxidative stress of peripheral blood leukocytes and possible linkages between oxidative stress and arsenic-induced skin lesions. 75 male inhabitants recruited from an As-endemic region of China were investigated in the present study. The classification of arsenicosis was based on the degree of skin lesions. Arsenic levels were measured in drinking water and urine by Atomic Fluorescence Spectroscopy. Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) was tested by Enzyme-Linked Immunosorbent Assay. 8-OHdG of peripheral blood leukocytes was evaluated using immunocytochemical staining. 8-OHdG-positive reactions were only present in polymorphonuclear leukocytes (PMNs), but not in monocytes (MNs). The 8-OHdG staining of PMN cytoplasm was observed in all investigated populations, while the 8-OHdG staining of PMN nuclei was frequently found along with the elevated amounts of cell debris in individuals with skin lesion. Urinary arsenic levels were increased in the severe skin lesion group compared with the normal group. No relationship was observed between drinking water arsenic or urine 8-OHdG and the degree of skin lesions. These findings indicated that the target and persistent oxidative stress in peripheral blood PMNs may be employed as a sensitive biomarker directly to assess adverse health effects caused by chronic exposure to lower levels of arsenic. -- Highlights: ► Male inhabitants were investigated from an As-endemic region of China. ► 8-OHdG-positive reactions were only present in polymorphonuclear leukocytes (PMNs). �

Prehistological evaluation of benign and malignant pigmented skin lesions with optical computed tomography

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Kokolakis, Athanasios; Zacharakis, Giannis; Krasagakis, Konstantin; Lasithiotakis, Konstantinos; Favicchio, Rosy; Spiliopoulos, George; Giannikaki, Elpida; Ripoll, Jorge; Tosca, Androniki

2012-06-01

Discrimination of benign and malignant melanocytic lesions is a major issue in clinical dermatology. Assessment of the thickness of melanoma is critical for prognosis and treatment selection. We aimed to evaluate a novel optical computed tomography (optical-CT) system as a tool for three-dimensional (3-D) imaging of melanocytic lesions and its ability to discriminate benign from malignant melanocytic lesions while simultaneously determining the thickness of invasive melanoma. Seventeen melanocytic lesions, one hemangioma, and normal skin were assessed immediately after their excision by optical-CT and subsequently underwent histopathological examination. Tomographic reconstructions were performed with a back-propagation algorithm calculating a 3-D map of the total attenuation coefficient (AC). There was a statistically significant difference between melanomas, dysplastic nevi, and non-dysplastic nevi, as indicated by Kruskal-Wallis test. Median AC values were higher for melanomas compared with dysplastic and non-dysplastic nevi. No statistically significant difference was observed when thickness values obtained by optical-CT were compared with histological thickness using a Wilcoxon sighed rank test. Our results suggest that optical-CT can be important for the immediate prehistological evaluation of biopsies, assisting the physician for a rapid assessment of malignancy and of the thickness of a melanocytic lesion.

Clinical studies of pigmented lesions in human skin by using a multiphoton tomograph

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Balu, Mihaela; Kelly, Kristen M.; Zachary, Christopher B.; Harris, Ronald M.; Krasieva, Tatiana B.; König, Karsten; Tromberg, Bruce J.

2013-02-01

In vivo imaging of pigmented lesions in human skin was performed with a clinical multiphoton microscopy (MPM)-based tomograph (MPTflex, JenLab, Germany). Two-photon excited fluorescence was used for visualizing endogenous fluorophores such as NADH/FAD, keratin, melanin in the epidermal cells and elastin fibers in the dermis. Collagen fibers were imaged by second harmonic generation. Our study involved in vivo imaging of benign melanocytic nevi, atypical nevi and melanoma. The goal of this preliminary study was to identify in vivo the characteristic features and their frequency in pigmented lesions at different stages (benign, atypical and malignant) and to evaluate the ability of in vivo MPM to distinguish atypical nevi from melanoma. Comparison with histopathology was performed for the biopsied lesions. Benign melanocytic nevi were characterized by the presence of nevus cell nests at the epidermal-dermal junction. In atypical nevi, features such as lentiginous hyperplasia, acanthosis and architectural disorder were imaged. Cytological atypia was present in all the melanoma lesions imaged, showing the strongest correlation with malignancy. The MPM images demonstrated very good correlation with corresponding histological images, suggesting that MPM could be a promising tool for in vivo non-invasive pigmented lesion diagnosis, particularly distinguishing atypical nevi from melanoma.

Skin lesions in European hibernating bats associated with Geomyces destructans, the etiologic agent of white-nose syndrome.

Science.gov (United States)

Wibbelt, Gudrun; Puechmaille, Sébastien J; Ohlendorf, Bernd; Mühldorfer, Kristin; Bosch, Thijs; Görföl, Tamás; Passior, Karsten; Kurth, Andreas; Lacremans, Daniel; Forget, Frédéric

2013-01-01

White-nose syndrome (WNS) has claimed the lives of millions of hibernating insectivorous bats in North America. Its etiologic agent, the psychrophilic fungus Geomyces destructans, causes skin lesions that are the hallmark of the disease. The fungal infection is characterized by a white powdery growth on muzzle, ears and wing membranes. While WNS may threaten some species of North American bats with regional extinction, infection in hibernating bats in Europe seems not to be associated with significant mortality. We performed histopathological investigations on biopsy samples of 11 hibernating European bats, originating from 4 different countries, colonized by G. destructans. One additional bat was euthanized to allow thorough examination of multiple strips of its wing membranes. Molecular analyses of touch imprints, swabs and skin samples confirmed that fungal structures were G. destructans. Additionally, archived field notes on hibernacula monitoring data in the Harz Mountains, Germany, over an 11-year period (2000-2011) revealed multiple capture-recapture events of 8 banded bats repeatedly displaying characteristic fungal colonization. Skin lesions of G. destructans-affected hibernating European bats are intriguingly similar to the epidermal lesions described in North American bats. Nevertheless, deep invasion of fungal hyphae into the dermal connective tissue with resulting ulceration like in North American bats was not observed in the biopsy samples of European bats; all lesions found were restricted to the layers of the epidermis and its adnexae. Two bats had mild epidermal cupping erosions as described for North American bats. The possible mechanisms for any difference in outcomes of G. destructans infection in European and North American bats still need to be elucidated.

Skin lesions in European hibernating bats associated with Geomyces destructans, the etiologic agent of white-nose syndrome.

Directory of Open Access Journals (Sweden)

Gudrun Wibbelt

Full Text Available White-nose syndrome (WNS has claimed the lives of millions of hibernating insectivorous bats in North America. Its etiologic agent, the psychrophilic fungus Geomyces destructans, causes skin lesions that are the hallmark of the disease. The fungal infection is characterized by a white powdery growth on muzzle, ears and wing membranes. While WNS may threaten some species of North American bats with regional extinction, infection in hibernating bats in Europe seems not to be associated with significant mortality. We performed histopathological investigations on biopsy samples of 11 hibernating European bats, originating from 4 different countries, colonized by G. destructans. One additional bat was euthanized to allow thorough examination of multiple strips of its wing membranes. Molecular analyses of touch imprints, swabs and skin samples confirmed that fungal structures were G. destructans. Additionally, archived field notes on hibernacula monitoring data in the Harz Mountains, Germany, over an 11-year period (2000-2011 revealed multiple capture-recapture events of 8 banded bats repeatedly displaying characteristic fungal colonization. Skin lesions of G. destructans-affected hibernating European bats are intriguingly similar to the epidermal lesions described in North American bats. Nevertheless, deep invasion of fungal hyphae into the dermal connective tissue with resulting ulceration like in North American bats was not observed in the biopsy samples of European bats; all lesions found were restricted to the layers of the epidermis and its adnexae. Two bats had mild epidermal cupping erosions as described for North American bats. The possible mechanisms for any difference in outcomes of G. destructans infection in European and North American bats still need to be elucidated.

Diagnostic imaging costs before and after digital tomosynthesis implementation in patient management after detection of suspected thoracic lesions on chest radiography.

Science.gov (United States)

Quaia, Emilio; Grisi, Guido; Baratella, Elisa; Cuttin, Roberto; Poillucci, Gabriele; Kus, Sara; Cova, Maria Assunta

2014-02-01

To evaluate diagnostic imaging costs before and after DTS implementation in patients with suspected thoracic lesions on CXR. Four hundred sixty-five patients (263 male, 202 female; age, 72.47 ± 11.33 years) with suspected thoracic lesion(s) after CXR underwent DTS. Each patient underwent CT when a pulmonary non-calcified lesion was identified by DTS while CT was not performed when a benign pulmonary or extrapulmonary lesion or pseudolesion was identified. The average per-patient imaging cost was calculated by normalising the costs before and after DTS implementation. In 229/465 patients who underwent DTS after suspicious CXR, DTS showed 193 pulmonary lesions and 36 pleural lesions, while in the remaining 236/465 patients, lesions were ruled out as pseudolesions of CXR. Chest CT examination was performed in 127/465 (27 %) patients while in the remaining 338/465 patients (73 %) CXR doubtful findings were resolved by DTS. The average per-patient costs of CXR, DTS and CT were 15.15, 41.55 and 113.66. DTS allowed an annual cost saving of 8,090.2 considering unenhanced CT and 19,298.12 considering contrast-enhanced CT. Considering a DTS reimbursement rate of 62.7 the break even point corresponds to 479 DTS examinations. Per-patient diagnostic imaging costs decreased after DTS implementation in patients with suspected thoracic lesions. • Digital tomosynthesis improves the diagnostic accuracy and confidence in chest radiography • Digital tomosynthesis reduces the need for CT for a suspected pulmonary lesion • Digital tomosynthesis requires a dose level equivalent to that of around two chest radiographies • Digital tomosynthesis produces a significant per-patient saving in diagnostic imaging costs.

Diagnostic value of dynamic perfusion MR imaging in benign and malignant musculoskeletal lesions

International Nuclear Information System (INIS)

Choi, Byeong Kyoo; Lee, Sang Hoon; Cha, Ji Hyeon; Kim, Sung Moon; Shin, Myung Jin; Han, Heon; Kim, Sam Soo; Lee, Ji Yeon; Jeon, Yong Hwan

2008-01-01

To assess the diagnostic value of dynamic perfusion MR imaging for differentiation between benign and malignant musculoskeletal lesions. Dynamic perfusion MR imaging was performed using a 3.0 T system in 32 female and 30 male patients (aged 10-90 years, mean age, 43 years). Following the assessment of the precontrast imaging, a dynamic study was performed. This dynamic technique allowed for 638 images to be obtained at 11 levels throughout the lesion. Twenty-eight lesions originated within bone (8 benign, 20 malignant), whereas 34 lesions were of soft tissue origin (22 benign, 12 malignant). The final diagnosis was histopathologically confirmed in all patients. To differentiate between benign and malignant lesions, we analyzed the four parameters: (maximal relative enhancement (MRE), time to peak (TTP), wash in rate (WI), steepest slope (SS) and the distribution of time intensity curve (TIC) patterns. The TTP, WI, and SS values of malignant lesions were statistically significant from those of benign lesions(ρ < 0.05). However, the difference for the MRE values was not statistically significant. The distribution of TIC patterns was a helpful indicator of benign or malignant state, however the difference between the two states was not significant. Dynamic perfusion MR imaging is a helpful tool in differentiating benign and malignant musculoskeletal lesions

A soft kinetic data structure for lesion border detection.

Science.gov (United States)

Kockara, Sinan; Mete, Mutlu; Yip, Vincent; Lee, Brendan; Aydin, Kemal

2010-06-15

The medical imaging and image processing techniques, ranging from microscopic to macroscopic, has become one of the main components of diagnostic procedures to assist dermatologists in their medical decision-making processes. Computer-aided segmentation and border detection on dermoscopic images is one of the core components of diagnostic procedures and therapeutic interventions for skin cancer. Automated assessment tools for dermoscopic images have become an important research field mainly because of inter- and intra-observer variations in human interpretations. In this study, a novel approach-graph spanner-for automatic border detection in dermoscopic images is proposed. In this approach, a proximity graph representation of dermoscopic images in order to detect regions and borders in skin lesion is presented. Graph spanner approach is examined on a set of 100 dermoscopic images whose manually drawn borders by a dermatologist are used as the ground truth. Error rates, false positives and false negatives along with true positives and true negatives are quantified by digitally comparing results with manually determined borders from a dermatologist. The results show that the highest precision and recall rates obtained to determine lesion boundaries are 100%. However, accuracy of assessment averages out at 97.72% and borders errors' mean is 2.28% for whole dataset.

High-frequency ultrasonography (HFUS as a useful tool in differentiating between plaque morphea and extragenital lichen sclerosus lesions

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Rafał Białynicki-Birula

2017-10-01

Full Text Available Introduction : Morphea and lichen sclerosus (LS are chronic inflammatory diseases that may pose a diagnostic challenge for a physician. High-frequency ultrasonography (HFUS is a versatile diagnostic method utilized in dermatologic practice, allowing monitoring the course of the disease, treatment response and differentiation between certain skin disorders. Aim : To prove the usefulness of HFUS in differentiating between plaque morphea and extragenital LS lesions. Material and methods : We examined 16 patients with plaque morphea and 4 patients with extragenital LS using 20 MHz taberna pro medicum TM (Germany device. Results : Investigations revealed hyperechogenic entrance echo in both morphea and LS lesions, whereas a distinct polycyclic surface of the entrance echo was detected exclusively in LS. Conclusions : High-frequency ultrasonography is a current diagnostic modality that may prove useful in differentiating between morphea and LS lesions.

Treatment of radiation skin lesions in various stages with different preparations of vitamin B12

International Nuclear Information System (INIS)

Ji Hui; Chen Qiang; Yang Xiaohong

1989-01-01

Since the aqueous solution of Vit. B 12 was firstly used to treat efficaciously the acute radiation injury of skin and superficial second-degree skin burn, we have successfully treated radiation skin lesions in acute, chronic and recovering stages with the cream or oil preparation of Vit. B 12 . In the period of ten years (1979-1988), altogether 418 cases of radiation or non-radiation skin injury were observed and 48 out of 49 cases with acute radiation skin ulcer treated with aqueous solution of Vit. B 12 were healed with an effective rate of 97.95% and average healing time of 12.6 days. All of 37 cases with chronic radiation skin injury treated with oil preparation of Vit. B 12 were healed or improved with an effective rate of 100% and average healing time of 21.49 days. However, in the control group, of 18 cases treated with conventional drugs only 13 were healed, the effective rate being 72.22% and healing time 63.5 days, and both of these indices were of significant difference, as compared with those treated with Vit. B 12

Expression of macrophage migration inhibitory factor in footpad skin lesions with diabetic neuropathy.

Science.gov (United States)

Up Noh, Sun; Lee, Won-Young; Kim, Won-Serk; Lee, Yong-Taek; Jae Yoon, Kyung

2018-01-01

Background Diabetic neuropathy originating in distal lower extremities is associated with pain early in the disease course, overwhelming in the feet. However, the pathogenesis of diabetic neuropathy remains unclear. Macrophage migration inhibitory factor has been implicated in the onset of neuropathic pain and the development of diabetes. Objective of this study was to observe pain syndromes elicited in the footpad of diabetic neuropathy rat model and to assess the contributory role of migration inhibitory factor in the pathogenesis of diabetic neuropathy. Methods Diabetic neuropathy was made in Sprague Dawley rats by streptozotocin. Pain threshold was evaluated using von Frey monofilaments for 24 weeks. On comparable experiment time after streptozotocin injection, all footpads were prepared for following procedures; glutathione assay, terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling staining, immunohistochemistry staining, real-time reverse transcription polymerase chain reaction, and Western blot. Additionally, human HaCaT skin keratinocytes were treated with methylglyoxal, transfected with migration inhibitory factor/control small interfering RNA, and prepared for real-time reverse transcription polymerase chain reaction and Western blot. Results As compared to sham group, pain threshold was significantly reduced in diabetic neuropathy group, and glutathione was decreased in footpad skin, simultaneously, cell death was increased. Over-expression of migration inhibitory factor, accompanied by low expression of glyoxalase-I and intraepidermal nerve fibers, was shown on the footpad skin lesions of diabetic neuropathy. But, there was no significance in expression of neurotransmitters and inflammatory mediators such as transient receptor potential vanilloid 1, mas-related G protein coupled receptor D, nuclear factor kappa B, tumor necrosis factor-alpha, and interleukin-6 between diabetic neuropathy group and sham group. Intriguingly

Diagnostic Accuracy and Inter-Observer Agreement of Shoulder Magnetic Resonance Arthrography in the Detection of Labral Lesion and Assessment of Lesion Location

Energy Technology Data Exchange (ETDEWEB)

Hwang, Ji Young; Song, Sook Yun; Choi, Jin Ha; Shin, Sang Jin [School of Medicine, Ewha Womans University, Mokdong Hospital, Seoul (Korea, Republic of)

2012-11-15

To evaluate the diagnostic accuracy and inter-observer agreement of magnetic resonance (MR) arthrography in the detection of labral lesions by location and to describe useful MR imaging findings of labral tears. Sixty-eight patients who underwent both pre-operative MR arthrography and arthroscopy were included. The location of the labrum was classified into anterior (2-6 o'clock), superior (12-2 o'clock), and posterior (6-12 o'clock). Sensitivity, specificity, accuracy, and inter-observer agreement of MR arthrography for the diagnosis of labral lesions by location were calculated. Frequency of MR imaging findings such as detachment, high signal intensity cleft, contour change, absence, and signal change of the labrum by location were analyzed. 35 anterior, 44 superior and 15 posterior labral lesions were detected by arthroscopy. The corresponding sensitivities were 91.4%, 79.5%, and 40.0%, specificities were 90.9%, 20.8%, and 86.8%, accuracies were 91.2%, 58.8%, and 76.5%, and kappa values were 0.823, 0.252, and 0.394, for anterior, superior, posterior lesions, respectively. The most common MR imaging findings were detachment in 60.0% of anterior labrums, high signal intensity cleft in 52.3% of superior labrums, and normal in 60.0% of posterior labrums. Diagnostic accuracy and inter-observer agreement of MR arthrography in the diagnosis of labral lesions are high in anterior labrums and low in superior or posterior labrums. The useful MR imaging findings of labral tears were different according to labral location.

Performance and Pain Tolerability of Current Diagnostic Allergy Skin Prick Test Devices.

Science.gov (United States)

Tversky, Jody R; Chelladurai, Yohalakshmi; McGready, John; Hamilton, Robert G

2015-01-01

Allergen skin prick testing remains an essential tool for diagnosing atopic disease and guiding treatment. Sensitivity needs to be defined for newly introduced devices. Our aim was to compare the performance of 10 current allergy skin prick test devices. Single- and multiheaded skin test devices (n = 10) were applied by a single operator in a prospective randomized manner. Histamine (1 and 6 mg/mL) and control diluent were introduced at 6 randomized locations onto the upper and lower arms of healthy subjects. Wheal and flare reactions were measured independently by 2 masked technicians. Twenty-four subjects provided consent, and 768 skin tests were placed. Mean wheal diameter among devices differed from 3.0 mm (ComforTen; Hollister-Stier, Spokane, Wash) to 6.8 mm (UniTest PC; Lincoln Diagnostics, Decatur, Ill) using 1 mg/mL histamine (P Diagnostics, Decatur, Ill; and Sharp-Test; Panatrex, Placentia, Calif) using 6 mg/mL histamine (P pain score of less than 4 on a 10-point visual analog scale. Pain scores were higher among women, but this did not reach statistical significance. The Multi-Test PC and the UniTest PC had the lowest pain scores compared with the other devices. All 10 skin prick test devices displayed good analytical sensitivity and specificity; however, 3 mm cannot arbitrarily be used as a positive threshold. The use of histamine at 1 mg/mL is unacceptable for certain devices but may be preferable for the most sensitive devices. On average, there was no pain score difference between multiheaded and single-head devices. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Determination of entrance skin dose from diagnostic X-ray of human ...

African Journals Online (AJOL)

patient during x-ray examination in Federal Medical Centre, Keffi in Nasarawa state, Nigeria. Entrance skin doses (ESDs) for a common type of x-ray procedures, namely chest AP/PA (anterior/posterior) were measured. A total of 200 data were collected from patients who were exposed to diagnostic X-ray during their routine ...

Potential of confocal laser scanning microscopy for non-invasive diagnostics of malignant epithelial skin tumors in the course of dermatoheliosis progression

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E. S. Snarskaya

2016-01-01

Full Text Available Most cases of malignant epithelial skin neoplasms including actinic keratosis and basal cell carcinoma, which are characterized by the most complicated course and numerous clinical and morphological options, involve dermatoheliosis progression. The risk of actinic keratosis transformation into basal cell carcinoma varies from 0.1% to 20% and up to 80% in cases of multiple AK lesion foci. A non-invasive method known as reflectance confocal laser scanning microscopy is the most promising one for the purposes of early diagnostics of signs pointing at epithelial skin neoplasm development and makes it possible to monitor the tumor in progress in vivo to diagnose the presence of a pool of squamous cells on a timely basis. The confocal laser scanning microscopy method provides high-contrast images of for any horizontal-oriented morphologic structures in the epidermis and upper dermis with a resolution comparable to those characteristic of traditional optical microscopy of skin tissue samples. According to our data obtained as a result of studying dynamic changes and morphologic structures in actinic keratosis foci (50 cases using the confocal laser scanning microscopy method, we discovered a number of morphologic features, and their further analysis will distinguish the signs of progressing carcinogenesis in case of dermatoheliosis.

Problems and complications of full-face carbon dioxide laser resurfacing for pathological lesions of the skin.

Science.gov (United States)

Read-Fuller, Andrew M; Yates, David M; Vu, David D; Hoopman, John E; Finn, Richard A

2017-01-01

Facial resurfacing with a CO 2 laser has been used for treatment of pathologic lesions and for cosmetic purposes. Postoperative complications and problems after laser resurfacing include infections, acneiform lesions, and pigment changes. This retrospective study describes the most common problems and complications in 105 patients and assesses postoperative pain in 38 patients. All patients received CO 2 laser resurfacing for treatment of malignant/premalignant lesions and had postoperative follow-up to assess problems and complications. Some had follow-up to assess postoperative pain. All patients had Fitzpatrick I-III skin types and underwent the same perioperative care regimen. There were 11 problems and 2 complications. Problems included infection, acneiform lesion/milia, and uncontrolled postoperative pain. Complications included hyperpigmentation. Among the postoperative pain group, 53% reported no pain and the rest had mild or moderate pain. Complications are rare. Infection and acneiform lesions/milia were the most common problems, as previously reported. Most patients do not experience postoperative pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Skin lesions in the tail of the spiny dogfish, Squalus acanthias L

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Woodhead, A D

1982-01-01

There are numerous reports of diseases and lesions of the major organs of a wide spectrum of bony fishes. By contrast, very few cases have been reported from elasmobranchs. This lack of information may reflect the fact that commercial exploitation of elasmobranch populations has been limited, although for several decades there have been fisheries for the spiny dogfish, Squalus acanthias L., in European waters. In both cases, many thousands of spiny dogfish have been sampled for population analysis. Further, the spiny dogfish has been dissected in senior biology courses in the UK for about 30 years and probably 5000 students take these courses annually. It is remarkable, with these numbers dissected, that so few lesions have been recorded. During the summer of 1980, whilst working at the Mount Desert Island Biological Laboratory, Maine, researchers sampled a large spiny dogfish which had a prominently engorged tail with numerous skin lesions. The fish was a mature female 100 cm long, weighing 6.5 kg, which was carrying 16 embryos in their second year of development. The dogfish was also remarkable in that one of the embryos had a marked developmental abnormality, its spinal column being severely twisted. Developmental damage appears to be unusual in dogfish and the embryo was examined further to see whether the damage might be related to the lesion of the mother.

Diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting trochlear ridge osteochondrosis lesions in the equine stifle.

Science.gov (United States)

Beccati, Francesca; Chalmers, Heather J; Dante, Sara; Lotto, Eleonora; Pepe, Marco

2013-01-01

Osteochondrosis lesions commonly occur on the femoral trochlear ridges in horses and radiography and ultrasonography are routinely used to diagnose these lesions. However, poor correlation has been found between radiographic and arthroscopic findings of affected trochlear ridges. Interobserver agreement for ultrasonographic diagnoses and correlation between ultrasonographic and arthroscopic findings have not been previously described. Objectives of this study were to describe diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting and grading osteochondrosis lesions of the equine trochlear ridges, using arthroscopy as the reference standard. Twenty-two horses were sampled. Two observers independently recorded radiographic and ultrasonographic findings without knowledge of arthroscopic findings. Imaging findings were compared between observers and with arthroscopic findings. Agreement between observers was moderate to excellent (κ 0.48-0.86) for detecting lesions using radiography and good to excellent (κ 0.74-0.87) for grading lesions using radiography. Agreement between observers was good to excellent (κ 0.78-0.94) for detecting lesions using ultrasonography and very good to excellent (κ 0.86-0.93) for grading lesions using ultrasonography. Diagnostic sensitivity was 84-88% for radiography and 100% for ultrasonography. Diagnostic specificity was 89-100% for radiography and 60-82% for ultrasonography. Agreement between radiography and arthroscopy was good (κ 0.64-0.78). Agreement between ultrasonography and arthroscopy was very good to excellent (κ 0.81-0.87). Findings from this study support ultrasound as a preferred method for predicting presence and severity of osteochondrosis lesions involving the femoral trochlear ridges in horses. © 2012 Veterinary Radiology & Ultrasound.

Interface dermatitis in skin lesions of Kikuchi-Fujimoto's disease: a histopathological marker of evolution into systemic lupus erythematosus?

Science.gov (United States)

Paradela, S; Lorenzo, J; Martínez-Gómez, W; Yebra-Pimentel, T; Valbuena, L; Fonseca, E

2008-12-01

Kikuchi's disease (KD) is a self-limiting histiocytic necrotizing lymphadenitis (HNL). Cutaneous manifestations are frequent and usually show histopathological findings similar to those observed in the involved lymph nodes. HNL with superposed histological features to KD has been described in patients with lupus erythematosus (LE), and a group of healthy patients previously reported as having HNL may evolve into LE after several months. Up to date, features to predict which HNL patients will have a self-limiting disease and which could develop LE have been not identified. In order to clarify the characteristics of skin lesions associated with KD, we report a case of HNL with evolution into systemic lupus erythematosus (SLE) and a review of previous reports of KD with cutaneous manifestations. A 17-year-old woman presented with a 4-month history of fever and generalised lymphadenopathy. A diagnosis of HNL was established based on a lymph node biopsy. One month later, she developed an erythematoedematous rash on her upper body, with histopathological findings of interface dermatitis. After 8 months, anti-nuclear antibodies (ANA) at titre of 1/320, anti-DNA-ds antibodies and marked decrease of complement levels were detected. During the following 2 years, she developed diagnostic criteria for SLE, with arthralgias, pleuritis, aseptic meningitis, haemolytic anaemia and lupus nephritis. To our knowledge, 27 cases of nodal and cutaneous KD have been reported, 9 of which later developed LE. In all these patients, the skin biopsy revealed interface dermatitis. Skin biopsy revealed a pattern of interface dermatitis in all reviewed KD cases, which evolved into LE. Even this histopathological finding was not previously considered significant; it might be a marker of evolution into LE.

Efficacy of diagnostic magnetic resonance imaging for articular cartilage lesions of the glenohumeral joint in patients with instability

International Nuclear Information System (INIS)

Hayes, Meredith L.; Collins, Mark S.; Wenger, Doris E.; Morgan, Joseph A.; Dahm, Diane L.

2010-01-01

The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions. A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy. Mean patient age was 27.0 ± 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89). Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non

Efficacy of diagnostic magnetic resonance imaging for articular cartilage lesions of the glenohumeral joint in patients with instability

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Hayes, Meredith L.; Collins, Mark S.; Wenger, Doris E. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Morgan, Joseph A.; Dahm, Diane L. [Mayo Clinic, Department of Orthopaedic Surgery, Rochester, MN (United States)

2010-12-15

The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions. A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy. Mean patient age was 27.0 {+-} 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89). Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non

Skin absorption through atopic dermatitis skin

DEFF Research Database (Denmark)

Halling-Overgaard, A-S; Kezic, S; Jakasa, I

2017-01-01

Patients with atopic dermatitis have skin barrier impairment in both lesional and non-lesional skin. They are typically exposed to emollients daily and topical anti-inflammatory medicaments intermittently, hereby increasing the risk of developing contact allergy and systemic exposed to chemicals...... ingredients found in these topical preparations. We systematically searched for studies that investigated skin absorption of various penetrants, including medicaments, in atopic dermatitis patients, but also animals with experimentally induced dermatitis. We identified 40 articles, i.e. 11 human studies...... examining model penetrants, 26 human studies examining atopic dermatitis drugs and 3 animal studies. We conclude that atopic dermatitis patients have nearly two-fold increased skin absorption when compared to healthy controls. There is a need for well-designed epidemiological and dermato...

Artificial neural networks for processing fluorescence spectroscopy data in skin cancer diagnostics

International Nuclear Information System (INIS)

Lenhardt, L; Zeković, I; Dramićanin, T; Dramićanin, M D

2013-01-01

Over the years various optical spectroscopic techniques have been widely used as diagnostic tools in the discrimination of many types of malignant diseases. Recently, synchronous fluorescent spectroscopy (SFS) coupled with chemometrics has been applied in cancer diagnostics. The SFS method involves simultaneous scanning of both emission and excitation wavelengths while keeping the interval of wavelengths (constant-wavelength mode) or frequencies (constant-energy mode) between them constant. This method is fast, relatively inexpensive, sensitive and non-invasive. Total synchronous fluorescence spectra of normal skin, nevus and melanoma samples were used as input for training of artificial neural networks. Two different types of artificial neural networks were trained, the self-organizing map and the feed-forward neural network. Histopathology results of investigated skin samples were used as the gold standard for network output. Based on the obtained classification success rate of neural networks, we concluded that both networks provided high sensitivity with classification errors between 2 and 4%. (paper)

Diagnostic Accuracy and Pitfalls of Preoperative Fine Needle Aspiration Cytology in Salivary Gland Lesions

International Nuclear Information System (INIS)

TAHOUN, N.; EZZAT, N.

2008-01-01

Purpose: Evaluation of diagnostic accuracy of preoperative fine needle aspiration cytology (FNAC) in salivary gland lesions. Patients and Methods: This is a retrospective study of 82 patients presented at NCI, Cairo University with salivary gland lesion who underwent preoperative FNAC diagnosis with subsequent excision and histopathologic assessment. Cytology results were classified as negative, positive, suspicious for cancer and inadequate. The definitive histopathologic report according to WHO Histological typing was the gold standard diagnosis against which FNAC was compared. Results: Our study included 82 patients who underwent preoperative FNAC of major salivary glands with subsequent surgical excision. Male to female ratio was 1.4: 1. The median age was 42 years. Parotid gland was involved in (68.3%), submandibular in (28%) and sub mental gland in (3.7%). Forty cases (48.8%) were cytologically diagnosed as benign lesions, 26 (31.7%) were malignant and 10 (12.2%) were suspicious. Cytological findings were non diagnostic in 6 (7.3%). The most common benign cytologic diagnosis was pleomorphic adenoma; 16 out of 40 cases (40%), while the most common malignant tumor was carcinoma; 22 out of 26 cases (84.6%). Cytologic diagnoses were compared with histopathologic ones and were true-negative in 37 (92.5%), true-positive in 33 (91.6%), false-negative in 3 (8.3%) and false-positive in 3 (7.5%) cases regarding detection of malignant tumors. The cytologic diagnosis achieved a sensitivity of 91.7%; a specificity of 92.5%, PPV 91.6%, NPV 92.5% and diagnostic accuracy 92%. The rates of agreement of histopathologic type for benign and malignant tumors were 89.2% and 91%, respectively. Conclusion: The sensitivity, specificity and diagnostic accuracy of FNAC were 91.7%, 92.5% and 92%, respectively. Attention to subtle morphologic changes, pitfalls and limitations are important to increase diagnostic accuracy. Multidirectional aspiration is preferred to avoid selective

CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

International Nuclear Information System (INIS)

Stattaus, Joerg; Kuehl, Hilmar; Ladd, Susanne; Schroeder, Tobias; Antoch, Gerald; Baba, Hideo A.; Barkhausen, Joerg; Forsting, Michael

2007-01-01

Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results

Diagnostic value of virtual touch tissue imaging quantification for benign and malignant breast lesions with different sizes

Science.gov (United States)

Liu, Hui; Zhao, Li-Xia; Xu, Guang; Yao, Ming-Hua; Zhang, Ai-Hong; Xu, Hui-Xiong; Wu, Rong

2015-01-01

The study was to explore diagnostic value of the virtual touch tissue imaging quantification (VTIQ) in distinguishing benign and malignant breast lesions of variable sizes. We performed conventional ultrasound and VTIQ in 139 breast lesions. The lesions were categorized into three groups according to size (group 1, ≤ 10 mm; group 2, 10-20 mm; and group 3, > 20 mm), and their mean, min, and max shear wave velocities (SWVs) were measured. Diagnoses were confirmed by pathological examination after surgery or needle biopsy. Receiver-operating characteristic curves (ROC) were constructed to determine the optimum cut-off values, calculate the area under curve (AUC), the sensitivity, specificity and accuracy for each velocity. For all groups, the mean, min, and max SWVs of malignant lesions were significantly higher than those of benign lesions (P < 0.05). The cut-off values of mean, min, and max SWVs were not significantly different among the three groups. In addition, the diagnostic performance of mean, min, and max SWV values is analogous, regardless of lesion size. In conclusion, VTIQ is a strong complement to conventional ultrasound, which is a promising method in the differential diagnosis of the breast lesions with different sizes. Further studies validate our results as well as reduce the number of unnecessary biopsies, regardless of size is warranted. PMID:26550234

An overlap of angiolymphoid hyperplasia with eosinophilia and Kimura′s disease: Successful treatment of skin lesions with cryotherapy

Directory of Open Access Journals (Sweden)

Praveen Kumar S Reddy

2015-01-01

Full Text Available Kimura′s disease is characterized by a triad of painless subcutaneous masses, eosinophilia in the peripheral blood and in tissues with marked increase in Serum Ig E. Angiolymphoid hyperplasia with eosinophilia (ALHE manifests with the presence of dermal papules and nodules. Unique clinical, histopathological, and biochemical findings are noted in these individual entities. A 32-year-female presented with multiple nodules in the axillae for 2 years. Peripheral smear showed eosinophilia with AEC of 6080. Histopathological examination showed features of overlap. Antinuclear antibody immunoflorescence was was negative. CD31, CD34, and FVIII were positive in vascular component. A CT chest revealed left axillary lymphadenopathy. The patient was treated with Cryotherapy and there was complete regression of skin lesions, with no recurrence after 1 year of follow-up. ALHE and KD are common in the head and neck region, but no reports of an overlap, presenting with lesions in the axillae are available to date, to the best of our knowledge. Response of skin lesions to cryotherapy is highlighted.

6-Shogaol, an active compound of ginger, alleviates allergic dermatitis-like skin lesions via cytokine inhibition by activating the Nrf2 pathway

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Park, Gunhyuk, E-mail: uranos5@kiom.re.kr [The K-herb Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054 (Korea, Republic of); Oh, Dal-Seok [The K-herb Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054 (Korea, Republic of); Lee, Mi Gi; Lee, Chang Eon [Major in Cosmeceutical Science, Division of Bio-technology and Convergence, Daegu Haany University, Gyeongsan (Korea, Republic of); Kim, Yong-ung, E-mail: ykim@dhu.ac.kr [Department of Pharmaceutical Engineering, College of Biomedical Science, Daegu Haany University (Korea, Republic of)

2016-11-01

Allergic dermatitis (AD) clinically presents with skin erythematous plaques, eruption, and elevated serum IgE, and T helper cell type 2 and 1 (Th2 and Th1) cytokine levels. 6-Shogaol [1-(4-hydroxy-methoxyphenyl)-4-decen-one], a pungent compound isolated from ginger, has shown anti-inflammatory effects, but its inhibitory effects on AD are unknown. The aim of this study was to examine whether 6-shogaol inhibits AD-like skin lesions and their underlying mechanism in vivo and in vitro. An AD-like response was induced by tumor necrosis factor-α (TNF-α) + IFN-γ in human keratinocytes or by 2,4-dinitrochlorobenzene (DNCB) in mice. In vivo, 6-shogaol inhibited the development of DNCB-induced AD-like skin lesions and scratching behavior, and showed significant reduction in Th2/1-mediated inflammatory cytokines, IgE, TNF-α, IFN-γ, thymus and activation-regulated chemokine, IL-1, 4, 12, and 13, cyclooxygenase-2, and nitric oxide synthase levels. In vitro, 6-shogaol inhibited reactive oxygen species (ROS) and mitogen-activated protein kinases (MAPKs) signaling, and increased the levels of total glutathione, heme oxygenase-1, and quinone 1 via nuclear factor erythroid 2 related factor 2 (Nrf2) activation. 6-Shogaol can alleviate AD-like skin lesions by inhibiting immune mediators via regulating the ROS/MAPKs/Nrf2 signaling pathway, and may be an effective alternative therapy for AD. - Highlights: • 6-Shogaol inhibited Th2/1-mediated inflammatory mediators in vitro and in vivo. • 6-Shogaol regulated ROS/MAPKs/Nrf2 signaling pathway. • 6-Shogaol can protect against the development of AD-like skin lesions.

6-Shogaol, an active compound of ginger, alleviates allergic dermatitis-like skin lesions via cytokine inhibition by activating the Nrf2 pathway

International Nuclear Information System (INIS)

Park, Gunhyuk; Oh, Dal-Seok; Lee, Mi Gi; Lee, Chang Eon; Kim, Yong-ung

2016-01-01

Allergic dermatitis (AD) clinically presents with skin erythematous plaques, eruption, and elevated serum IgE, and T helper cell type 2 and 1 (Th2 and Th1) cytokine levels. 6-Shogaol [1-(4-hydroxy-methoxyphenyl)-4-decen-one], a pungent compound isolated from ginger, has shown anti-inflammatory effects, but its inhibitory effects on AD are unknown. The aim of this study was to examine whether 6-shogaol inhibits AD-like skin lesions and their underlying mechanism in vivo and in vitro. An AD-like response was induced by tumor necrosis factor-α (TNF-α) + IFN-γ in human keratinocytes or by 2,4-dinitrochlorobenzene (DNCB) in mice. In vivo, 6-shogaol inhibited the development of DNCB-induced AD-like skin lesions and scratching behavior, and showed significant reduction in Th2/1-mediated inflammatory cytokines, IgE, TNF-α, IFN-γ, thymus and activation-regulated chemokine, IL-1, 4, 12, and 13, cyclooxygenase-2, and nitric oxide synthase levels. In vitro, 6-shogaol inhibited reactive oxygen species (ROS) and mitogen-activated protein kinases (MAPKs) signaling, and increased the levels of total glutathione, heme oxygenase-1, and quinone 1 via nuclear factor erythroid 2 related factor 2 (Nrf2) activation. 6-Shogaol can alleviate AD-like skin lesions by inhibiting immune mediators via regulating the ROS/MAPKs/Nrf2 signaling pathway, and may be an effective alternative therapy for AD. - Highlights: • 6-Shogaol inhibited Th2/1-mediated inflammatory mediators in vitro and in vivo. • 6-Shogaol regulated ROS/MAPKs/Nrf2 signaling pathway. • 6-Shogaol can protect against the development of AD-like skin lesions.

An improved strategy for skin lesion detection and classification using uniform segmentation and feature selection based approach.

Science.gov (United States)

Nasir, Muhammad; Attique Khan, Muhammad; Sharif, Muhammad; Lali, Ikram Ullah; Saba, Tanzila; Iqbal, Tassawar

2018-02-21

Melanoma is the deadliest type of skin cancer with highest mortality rate. However, the annihilation in early stage implies a high survival rate therefore, it demands early diagnosis. The accustomed diagnosis methods are costly and cumbersome due to the involvement of experienced experts as well as the requirements for highly equipped environment. The recent advancements in computerized solutions for these diagnoses are highly promising with improved accuracy and efficiency. In this article, we proposed a method for the classification of melanoma and benign skin lesions. Our approach integrates preprocessing, lesion segmentation, features extraction, features selection, and classification. Preprocessing is executed in the context of hair removal by DullRazor, whereas lesion texture and color information are utilized to enhance the lesion contrast. In lesion segmentation, a hybrid technique has been implemented and results are fused using additive law of probability. Serial based method is applied subsequently that extracts and fuses the traits such as color, texture, and HOG (shape). The fused features are selected afterwards by implementing a novel Boltzman Entropy method. Finally, the selected features are classified by Support Vector Machine. The proposed method is evaluated on publically available data set PH2. Our approach has provided promising results of sensitivity 97.7%, specificity 96.7%, accuracy 97.5%, and F-score 97.5%, which are significantly better than the results of existing methods available on the same data set. The proposed method detects and classifies melanoma significantly good as compared to existing methods. © 2018 Wiley Periodicals, Inc.

Evaluation of entrance skin dose to the skull in diagnostic radiology

International Nuclear Information System (INIS)

Mohamed, Anas Ali Elbushari

2015-12-01

Diagnostic x-ray radiology is a common diagnostic practice.Despite of its increasing hazard to human beings, imaging procedures should be achieved with less radiation dose and sufficient image quality. The aim of this study was to estimate the entrance skin dose(ESD) for patients undergoing selected diagnostic x-ray examinations in four hospitals.The study included the examinations of the skull; posterior- anterior(PA) and lateral projections. Fifty patients were enrolled in this study. ESDs were estimated from patients specific exposure parameters using established relation between output (μGy/mAs) and tube voltage(kVp). The estimated ESDs ranged from 0.0097-0.1846 mGy for skull (PA), 0.0097-0.1399 mGy for skull (LAT). These values were acceptable as compared with the international reference dose levels. This study provides additional data that can help the regulatory authority to establish reference dose levels for diagnostic radiology in Sudan.(Author)

Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

Science.gov (United States)

Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

2016-03-01

Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN. © 2015 Japanese Dermatological Association.

Mycotic skin lesions in an adult reindeer caused by Debaryomyces bansenii. A case report

Directory of Open Access Journals (Sweden)

Claes Rehbinder

1994-12-01

Full Text Available This report apparently is the first to describe candidosis in reindeer. It is imperative that reindeer kept in corrals during winter and spring for supplementary feeding, are provided clean, dry conditions and that strict hygenic measures are followed. If reindeer on the other hand are kept in dirty, wet and muddy corrals, among other things, skin lesions due to fungal infections may possibly appear rather frequently.

[The morphological characteristic of the skin lesions inflicted by plastic knives with four cutting edges].

Science.gov (United States)

Leonov, S V; Finkel'shtein, V T

2015-01-01

The objective of the present work was to study the morphological features of the skin lesions inflicted by the blades of the Fgx Boot Blade I knives having four cutting edges. The study revealed the signs that can be used to distinguish between morphological characteristics of the stab and lacerated wounds having the primary and secondary incisions made by the four-edge blade.

Diagnostic signs of motor neuropathy in MR neurography: Nerve lesions and muscle denervation

International Nuclear Information System (INIS)

Schwarz, Daniel; Pham, Mirko; Bendszus, Martin; Baeumer, Philipp; Weiler, Markus; Heiland, Sabine

2015-01-01

To investigate the diagnostic contribution of T2-w nerve lesions and of muscle denervation in peripheral motor neuropathies by magnetic resonance neurography (MRN). Fifty-one patients with peripheral motor neuropathies underwent high-resolution MRN by large coverage axial T2-w sequences of the upper arm, elbow, and forearm. Images were evaluated by two blinded readers for T2-w signal alterations of median, ulnar, and radial nerves, and for denervation in respective target muscle groups. All 51 patients displayed nerve lesions in at least one of three nerves, and 43 out of 51 patients showed denervation in at least one target muscle group of these nerves. In 21 out of 51 patients, the number of affected nerves matched the number of affected target muscle groups. In the remaining 30 patients, T2-w lesions were encountered more frequently than target muscle group denervation. In 153 nerve-muscle pairs, 72 showed denervation, but only one had increased muscle signal without a lesion in the corresponding nerve. MRN-based diagnosis of peripheral motor neuropathies is more likely by visualization of peripheral nerve lesions than by denervation in corresponding target muscles. Increased muscular T2-w signal without concomitant nerve lesions should raise suspicion of an etiology other than peripheral neuropathy. (orig.)

Diagnostic signs of motor neuropathy in MR neurography: Nerve lesions and muscle denervation

Energy Technology Data Exchange (ETDEWEB)

Schwarz, Daniel; Pham, Mirko; Bendszus, Martin; Baeumer, Philipp [Heidelberg University Hospital, Department of Neuroradiology, Heidelberg (Germany); Weiler, Markus [Heidelberg University Hospital, Department of Neurology, Heidelberg (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Neurooncology, Heidelberg (Germany); Heiland, Sabine [Heidelberg University Hospital, Section of Experimental Radiology, Department of Neuroradiology, Heidelberg (Germany)

2015-05-01

To investigate the diagnostic contribution of T2-w nerve lesions and of muscle denervation in peripheral motor neuropathies by magnetic resonance neurography (MRN). Fifty-one patients with peripheral motor neuropathies underwent high-resolution MRN by large coverage axial T2-w sequences of the upper arm, elbow, and forearm. Images were evaluated by two blinded readers for T2-w signal alterations of median, ulnar, and radial nerves, and for denervation in respective target muscle groups. All 51 patients displayed nerve lesions in at least one of three nerves, and 43 out of 51 patients showed denervation in at least one target muscle group of these nerves. In 21 out of 51 patients, the number of affected nerves matched the number of affected target muscle groups. In the remaining 30 patients, T2-w lesions were encountered more frequently than target muscle group denervation. In 153 nerve-muscle pairs, 72 showed denervation, but only one had increased muscle signal without a lesion in the corresponding nerve. MRN-based diagnosis of peripheral motor neuropathies is more likely by visualization of peripheral nerve lesions than by denervation in corresponding target muscles. Increased muscular T2-w signal without concomitant nerve lesions should raise suspicion of an etiology other than peripheral neuropathy. (orig.)

Topical treatment of malignant and premalignant skin lesions by very low concentrations of a standard mixture (BEC) of solasodine glycosides.

Science.gov (United States)

Cham, B E; Daunter, B; Evans, R A

1991-09-01

A cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) has been shown to be effective in the treatment of malignant and benign human skin tumours. We now report that a preparation (Curaderm) which contains very low concentrations of BEC (0.005%) is effective in the treatment of keratoses, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin of humans. In an open study, clinical and histological observations indicated that all lesions (56 keratoses, 39 BCCs and 29 SCCs) treated with Curaderm had regressed. A placebo formulation had no effect on a smaller number of treated lesions. Curaderm had no adverse effect on the liver, kidneys or haematopoietic system.

Bee Venom Phospholipase A2 Alleviate House Dust Mite-Induced Atopic Dermatitis-Like Skin Lesions by the CD206 Mannose Receptor

OpenAIRE

Dasom Shin; Won Choi; Hyunsu Bae

2018-01-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by highly pruritic, erythematous, and eczematous skin plaques. We previously reported that phospholipase A2 (PLA2) derived from bee venom alleviates AD-like skin lesions induced by 2,4-dinitrochlorobenzene (DNCB) and house dust mite extract (Dermatophagoides farinae extract, DFE) in a murine model. However, the underlying mechanisms of PLA2 action in actopic dermatitis remain unclear. In this study, we showed that PLA...

Low selenium status affects arsenic metabolites in an arsenic exposed population with skin lesions.

Science.gov (United States)

Huang, Zhi; Pei, Qiuling; Sun, Guifan; Zhang, Sichum; Liang, Jiang; Gao, Yi; Zhang, Xinrong

2008-01-01

The antagonistic effects between selenium (Se) and arsenic (As) suggest that low selenium status plays important roles in arsenism development. However, no study has been reported for humans suffering from chronic arsenic exposure with low selenium status. Sixty-three subjects were divided into 2 experimental groups by skin lesions (including hyperkeratosis, depigmentation, and hyperpigmentation). Total urine and serum concentrations of arsenic and selenium were determined by ICP-MS with collision/reaction cell. Arsenic species were analysed by ICP-MS coupled with HPLC. The mean concentration of As in the drinking waters was 41.5 microg/l. The selenium dietary intake for the studied population was 31.7 microg Se/d, and which for the cases and controls were 25.9 and 36.3 microg Se/d, respectively. Compared with the controls, the skin lesions cases had lower selenium concentrations in serum and urine (41.4 vs 49.6 microg/l and 71.0 vs 78.8 microg/l, respectively), higher inorganic arsenic (iAs) in serum (5.2 vs 3.4 microg/l, PiAs in serum and urine (20.2) vs 16.9% and 18.3 vs 14.5%, respectively, PiAs and its inhibition to be biotransformed to DMA occurred in human due to chronic exposure of low selenium status.

Diagnostic imaging strategy for MDCT- or MRI-detected breast lesions: use of targeted sonography

International Nuclear Information System (INIS)

Nakano, Satoko; Ohtsuka, Masahiko; Mibu, Akemi; Karikomi, Masato; Sakata, Hitomi; Yamamoto, Masahiro

2012-01-01

Leading-edge technology such as magnetic resonance imaging (MRI) or computed tomography (CT) often reveals mammographically and ultrasonographically occult lesions. MRI is a well-documented, effective tool to evaluate these lesions; however, the detection rate of targeted sonography varies for MRI detected lesions, and its significance is not well established in diagnostic strategy of MRI detected lesions. We assessed the utility of targeted sonography for multidetector-row CT (MDCT)- or MRI-detected lesions in practice. We retrospectively reviewed 695 patients with newly diagnosed breast cancer who were candidates for breast conserving surgery and underwent MDCT or MRI in our hospital between January 2004 and March 2011. Targeted sonography was performed in all MDCT- or MRI-detected lesions followed by imaging-guided biopsy. Patient background, histopathology features and the sizes of the lesions were compared among benign, malignant and follow-up groups. Of the 695 patients, 61 lesions in 56 patients were detected by MDCT or MRI. The MDCT- or MRI-detected lesions were identified by targeted sonography in 58 out of 61 lesions (95.1%). Patients with pathological diagnoses were significantly older and more likely to be postmenopausal than the follow-up patients. Pathological diagnosis proved to be benign in 20 cases and malignant in 25. The remaining 16 lesions have been followed up. Lesion size and shape were not significantly different among the benign, malignant and follow-up groups. Approximately 95% of MDCT- or MRI-detected lesions were identified by targeted sonography, and nearly half of these lesions were pathologically proven malignancies in this study. Targeted sonography is a useful modality for MDCT- or MRI-detected breast lesions

T lymphocytes in the lesional skin and the levels of peripheral blood cytokines in patients with psoriasis

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İbrahim Kökçam

2011-03-01

Full Text Available In the current study, it was aimed to investigate the roles of tissue cellular immunity and serum levels of cytokines in the patients with plaque psoriasis treated with calcipotriol-betamethasone dipropionate.Materials and methods: The study included 20 patients with psoriasis. Peripheral blood and biopsy samples were collected from lesional and normal skins before and after treatment. The results were compared with each other.Results: Immunohistochemical examination revealed significant elevations of CD4+, CD8+ and CD25+ T lymphocytes in the lesional tissues when compared to that in the healthy tissues and post treatment tissue (p0.05. The levels of IL–4, IL–10, TNF-α, IFN-γ and TGF-β1 in serum were not significantly different between before and after treatment periods (p>0.05.Conclusion: Our study demonstrated that there were infiltration of CD4+ and CD8+ cell in the lesional skin and CD8+ T-lymphocytes were the dominant cell types. The improvement of the lesions and significant decreases in CD4+ and CD8+ T-cells in accordance with the treatment strongly support the hypothesis that Th lymphocytes may have prominent roles in the immunopathogenesis of the disease. However, our findings showed that sufficient T-cells still remains in the tissue, which is consistent with the chronic characteristic of the disease, and the topical treatment could not be able to prevent the activation of the disease.

Diagnostic nerve ultrasonography

International Nuclear Information System (INIS)

Baeumer, T.; Grimm, A.; Schelle, T.

2017-01-01

For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

The diagnostic value of double-contrast-technique cystography in the evaluation of benign and malignant lesions of the urinary bladder

International Nuclear Information System (INIS)

Beyer, D.; Koester, R.; Schuett, H.

1979-01-01

Cystography by double-contrast-technique as simple and quick method of evaluating benign and malignant lesions of the urinary bladder is being described. 301 examinations were reviewed and are being discussed in regard to diagnostic value, indication, complication and radiation exposure of this method. A few typical cases are being demonstrated to illustrate the value of this method in the spectrum of other diagnostic methods in the workup of urinary bladder lesions. (orig.) [de

Identification and partial sequencing of a crocodile poxvirus associated with deeply penetrating skin lesions in farmed Nile crocodiles, Crocodylus niloticus.

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Huchzermeyer, F W; Wallace, D B; Putterill, J F; Gerdes, G H

2009-09-01

When large numbers of crocodile skins were downgraded because of the presence of small pin prick-like holes, collapsed epidermal cysts were found deep in the dermis of juvenile crocodiles while forming cysts were observed in hatchlings. Histopathology of these forming cysts showed the presence of intracytoplasmic inclusions in proliferating and ballooning epidermal cells. Pox virions were seen in electron microscope preparations made from the scabs of such early lesions. The partial sequencing of virus material from scrapings of these lesions and comparison of it with the published sequence of crocodile poxvirus showed the virus associated with the deep lesions to be closely related, but different. To differentiate between the two forms of crocodile pox infection it is suggested that the previously known form should be called "classical crocodile pox" and the newly discovered form "atypical crocodile pox". The application of strict hygiene measures brought about a decline in the percentage of downgraded skins.

Identification and partial sequencing of a crocodile poxvirus associated with deeply penetrating skin lesions in farmed Nile crocodiles, Crocodylus niloticus

Directory of Open Access Journals (Sweden)

F.W. Huchzermeyer

2009-09-01

Full Text Available When large numbers of crocodile skins were downgraded because of the presence of small pin pricklike holes, collapsed epidermal cysts were found deep in the dermis of juvenile crocodiles while forming cysts were observed in hatchlings. Histopathology of these forming cysts showed the presence of intracytoplasmic inclusions in proliferating and ballooning epidermal cells. Pox virions were seen in electron microscope preparations made from the scabs of such early lesions. The partial sequencing of virus material from scrapings of these lesions and comparison of it with the published sequence of crocodile poxvirus showed the virus associated with the deep lesions to be closely related, but different. To differentiate between the two forms of crocodile pox infection it is suggested that the previously known form should be called ''classical crocodile pox'' and the newly discovered form ''atypical crocodile pox''. The application of strict hygiene measures brought about a decline in the percentage of downgraded skins.

Diagnostic value of MR analysis of cartilaginous lesions compared with intraoperative arthroscopy in calcaneal fractures

International Nuclear Information System (INIS)

Schroeder, R.J.; Nekwasil, S.J.; Felix, R.; Hidajat, N.; Boack, D.H.; Haas, N.P.; Martus, P.

2005-01-01

Purpose: To determine the diagnostic value of MRI in preoperative analysis and classification of cartilaginous lesions - especially of the posterior facet - in traumatic calcaneal fractures compared with intraoperative arthroscopy. Materials and Methods: Twenty-four consecutive patients with traumatic calcaneal fractures underwent prospective MRI of the subtalar joint surface using T1- and T2-weighted spin echo sequences and fat suppressed 3D gradient echo sequences in semicoronal slice orientation (1.5 T MRI). After randomization, the images were analyzed by two blinded and independent readers experienced in MRI. The results were compared with the intraoperative arthroscopic findings as to location and depth of the defects using the Outerbridge classification. Results: We examined 12 calcaneal fractures of type 2, 8 of type 3 and 4 of type 4 according to the Sanders classification. With respect to principal detection and exact classification, 67 to 96 (69.8%) of all arthroscopic verified cartilaginous defects were diagnosed correctly by MRI. Disregarding the degree of the defects, 38 of 44 (86.4%) chondral lesions were detected (sensitivity: 86.4%, specificity: 86.5%, diagnostic accuracy: 86.5%). Considering the chondral lesions of degrees 3 and 4 together, the sensitivity was 86.0%, the specificity 86.8%, and the diagnostic accuracy 86.5%. Assessing these degrees separately, the sensitivity was only 33.3% for degree 3 and 58.1% for degree 4, whereas the specificity was definitely higher with 82.1% for degree 3 and 89.2% for degree 4. (orig.)

Goltz syndrome: A newborn with ectrodactyly and skin lesions

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Shatanik Sarkar

2015-01-01

Full Text Available Goltz syndrome or Focal Dermal Hypoplasia is a rare multisystem disorder, involving all the three germ cell layers. The disease is thought to be inherited in X-linked dominant fashion with heterogeneous mutations of the PORCN gene at Xp11.23 locus. Majority of the cases are sporadic, mainly due to postzygotic somatic mutations. The clinical spectrum includes characteristic cutaneous manifestations, multiple skeletal anomalies, and involvement of the eyes, hair, nails, kidneys, and so on. Considerable variability is noted in the clinical expression of the disease probably due to genomic mosaicism. Around 300 cases of Goltz syndrome have been reported in the literature. Here, we report such a case with characteristic skin lesions, multiple bony defects, distinctive facial features, coloboma of iris, and bilateral hydronephrosis. The diagnosis was evident immediately after birth due to the characteristic clinical picture of the baby.

Halting angiogenesis by non-viral somatic gene therapy alleviates psoriasis and murine psoriasiform skin lesions

DEFF Research Database (Denmark)

Zibert, John Robert; Wallbrecht, Katrin; Schön, Margarete

2011-01-01

Dysregulated angiogenesis is a hallmark of chronic inflammatory diseases, including psoriasis, a common skin disorder that affects approximately 2% of the population. Studying both human psoriasis in 2 complementary xenotransplantation models and psoriasis-like skin lesions in transgenic mice......-15) by in vivo electroporation reduced cutaneous angiogenesis and vascularization in all 3 models. As demonstrated using red fluorescent protein-coupled RDD, the treatment resulted in muscular expression of the gene product and its deposition within the cutaneous hyperangiogenic connective tissue....... High-resolution ultrasound revealed reduced cutaneous blood flow in vivo after electroporation with RDD but not with control plasmids. In addition, angiogenesis- and inflammation-related molecular markers, keratinocyte proliferation, epidermal thickness, and clinical disease scores were downregulated...

High-level intuitive features (HLIFs) for intuitive skin lesion description.

Science.gov (United States)

Amelard, Robert; Glaister, Jeffrey; Wong, Alexander; Clausi, David A

2015-03-01

A set of high-level intuitive features (HLIFs) is proposed to quantitatively describe melanoma in standard camera images. Melanoma is the deadliest form of skin cancer. With rising incidence rates and subjectivity in current clinical detection methods, there is a need for melanoma decision support systems. Feature extraction is a critical step in melanoma decision support systems. Existing feature sets for analyzing standard camera images are comprised of low-level features, which exist in high-dimensional feature spaces and limit the system's ability to convey intuitive diagnostic rationale. The proposed HLIFs were designed to model the ABCD criteria commonly used by dermatologists such that each HLIF represents a human-observable characteristic. As such, intuitive diagnostic rationale can be conveyed to the user. Experimental results show that concatenating the proposed HLIFs with a full low-level feature set increased classification accuracy, and that HLIFs were able to separate the data better than low-level features with statistical significance. An example of a graphical interface for providing intuitive rationale is given.

Non tuberculous mycobacterial lesion of the parotid gland and facial skin in a 4year old girl: A proposed treatment strategy.

Science.gov (United States)

Berkovic, Juraj; Vanchiere, John A; Gungor, Anil

2016-01-01

We report a case of a parotid-facial caseating granulomatous infection caused by atypical mycobacteria (Mycobacterium avium) in an immuno-competent child. The size and depth of the lesion and its proximity to the facial nerve present a challenge for a purely surgical treatment strategy. An alternative treatment strategy is developed to avoid severe disfigurement. Atypical mycobacterial infection of the parotid region in a 5 year old girl: timeline and definition of a planned combined treatment strategy with antibiotics and surgical excision. Cervicofacial infections caused by non-tuberculous mycobacteria (NTM) may present surgical challenges due to the size and depth of the lesion and its proximity to the facial nerve and major vascular structures. Even minor scars are highly visible and poorly tolerated. Close clinical monitoring combined with judicious treatment strategies is necessary for successful treatment and good cosmesis. Recent literature provides insufficient guidance in formulating the best treatment strategy for the individual patient. Comparisons of antibiotic therapy with variations of surgical excision are abundant but poorly formulated. Our case presented with a lesion involving skin, superficial and deep lobe of the parotid gland. Lesion was in immediate proximity to the distribution of the facial nerve through the parotid gland. The risk of surgical damage to the facial nerve in the acute phase of the inflammation and the required extent of skin excision were significant. We decided to start treatment with combination antimycobacterial antibiotics in close cooperation with the pediatric infectious disease specialists. We observed and documented the regress and executed a delayed surgical excision when the lesion was reduced to skin only. In our opinion this was the best treatment strategy that helped us avoid extensive dissection in the vicinity of the facial nerve as well as a parotidectomy. Excision of the involved skin with the deep portion

[Congenital "kissing" lesions: Nevus or "café au lait" spot?

Science.gov (United States)

Durazzo, A; Boccara, O; Fraitag, S; Fusade, T; Picard, A; Kadlub, N

2016-12-01

"Café au lait" spots (CLS) are pigmented skin lesions principally located at the trunk and the limbs. Histologically, CLSs consist in an excessive pigmentation of the epidermis, with no risk of malignant transformation. The "kissing" nevus is a rare pigmented congenital nevus affecting both lower and upper eyelids in a mirror layout. As other nevi, it presents a theoretical risk of malignant transformation. These two pigmented lesions are responsible for aesthetic discomfort when affecting the face. Three patients presenting with a congenital pigmented lesion affecting the two eyelids in a mirror layout are presented. In two cases, the lesions, initially considered as "kissing" nevi, were classified as CLSs. The diagnosis of CLS was made on a biopsy in one patient and after surgery in the other one. Pigmented mirror layout lesions, called "kissing" lesions, are exclusively described for the nevi. We describe two cases of CLSs affecting the eyelids in a mirror layout. Difficulties in diagnostic are exposed and the possible treatments are discussed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation.

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Bayat, Mahdi; Denis, Max; Gregory, Adriana; Mehrmohammadi, Mohammad; Kumar, Viksit; Meixner, Duane; Fazzio, Robert T; Fatemi, Mostafa; Alizad, Azra

2017-01-01

Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography (CUSE) performance in differentiating breast masses. With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients (19-85 years, mean 59.93±14.96 years) with 227 suspicious breast masses identifiable by ultrasound (mean size 1.83±2.45cm) were analyzed. CUSE was performed on all patients. Three regions of interest (ROI), 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young's modulus. In correlation to pathology results, statistical analyses were performed. Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions (BI-RADS 2 and 3) were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity (91 of 108), 89.92% specificity (107 of 119), 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve (P 0.21). CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their stiffness.

Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation.

Directory of Open Access Journals (Sweden)

Mahdi Bayat

Full Text Available Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography (CUSE performance in differentiating breast masses.With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients (19-85 years, mean 59.93±14.96 years with 227 suspicious breast masses identifiable by ultrasound (mean size 1.83±2.45cm were analyzed. CUSE was performed on all patients. Three regions of interest (ROI, 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young's modulus. In correlation to pathology results, statistical analyses were performed.Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions (BI-RADS 2 and 3 were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity (91 of 108, 89.92% specificity (107 of 119, 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve (P 0.21.CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their stiffness.

On the CT-diagnosis of optic nerve lesions. Differential diagnostic criteria

International Nuclear Information System (INIS)

Unsoeld, R.

1982-01-01

Computed tomograms of 166 optic nerve lesions were analyzed: 97 were mainly orbital and 69 mainly intracranial. The criteria were clinical course, size, density and delineation of the optic nerve shadow, orbital and cerebral soft tissue abnormalities, and bony changes in the optic canal. Characteristic CT features are described of individual disease entities such as optic gliomas, optic nerve sheath meningiomas, neoplastic and inflammatory infiltrations. The differential diagnostic importance of individual CT criteria is evaluated and discussed. Simultaneous visualization of orbital and intracranial soft tissue changes as well as bony changes in the optic canal allow the location and identification of the majority of optic nerve lesions based on the criteria mentioned above, and optic nerve tumors can be differentiated. In 9 patients with optic neuritis due to clinically proven encephalitis and in 17 patients with total optic atrophy, no changes in the size of the optic nerve could be found. CT evaluation of the intraorbital portion of the optic nerve requires special examination techniques. Oblique computer reformations through the optic canal provide excellent visualization of bony changes in the optic canal. The exclusion of intracranial causes of optic nerve lesions requires intravenous injection of contrast material. (orig.) [de

Association of malignancy with rapid growth in early lesions induced by irradiation of rat skin

International Nuclear Information System (INIS)

McGregor, J.F.

1979-01-01

Epithelial lesions induced by irradiation of rat skin were studied to determine (a) the relationship of malignancy to dose, (b) the types of lesions and circumstances leading to overt malignancy, and (c) the growth rates of lesions progressing to malignancy versus those of lesions remaining benign. High doses of radiation were shown to be associated with the production of epidermal cancers, the maximum yield being obtained at 6,400 rads. Conversely, a peak yield of noncancerous lesions was obtained at 1,600 rads. This association between malignancy and high dose was consistent for cancers evolving from warts, cysts, and chronic ulcers. Although the proportion of warts among the induced lesions was much higher than that of the cysts or chronic ulcers (76, 14, and 10%, respectively), the likelihood of warts becoming cancerous was substantially lower (14, 23, and 21%). The combined data for all doses showed that the latency period of the epidermal cancers was significantly (P = 0.015) shorter than that of the benign tumors. Rapid growth rates were observed for warts, cysts, and chronic ulcers progressing to overt cancer, and these did not overlap at any point on the growth scale with rates for benign tumors. This finding suggested that the potential for malignant development had been established early in the carcinogenic process, very likely at induction

[Diagnostic and Treatment Strategies in Morel-Lavallee Lesions in the Spinal Column and Pelvis].

Science.gov (United States)

Becker, Christopher A; Kammerlander, Christian; Greiner, Axel; Sommer, Fabian; Linhart, Christoph; Böcker, Wolfgang; Rubenbauer, Bianka; Weidert, Simon

2018-04-12

The Morel-Lavallée lesion is one of the concomitant soft tissue lesions of pelvic fractures. Its role in spine fractures and its treatment in combination with osteosynthesis of pelvic or spine fractures have not yet been determined. The aim of this study was to analyse the best diagnostic and treatment options of both spine and pelvic fractures combined with Morel-Lavallée lesions (MLL). An analysis of the literature was performed via PubMed and Medline. This revealed a total of 197 studies and case reports. After analysing the literature, 19 studies/case reports met our inclusion criteria. There are several diagnostic options for MLL, including ultrasound, computed tomography or MRI. In spinal and pelvic lesions, ultrasound is capable of detecting MLL. Some authors tend to perform open debridement of the MLL, whereas others recommend percutanous treatment. Open debridement and vacuum-assisted closure are recommended in late diagnosed MLL, where primary suture of the soft tissue is impossible. Fracture fixation should be performed simultaneously to treatment of the MLL. Broad-spectrum cephalosporins combined with an aminoglycoside or piperacilline/tazobactam should be initiated. Radical debridement and drainage are recommended, especially when MLL is diagnosed late. Repeated ultrasound examinations should be performed of the surrounding soft tissue of the fracture. When MLL is diagnosed within 2 days, percutanous fracture and MLL treatment should be performed. After more than 2 days, both fracture and MLL should be treated with open debridement, open fracture fixation and primary suture if possible. Georg Thieme Verlag KG Stuttgart · New York.

CT-guided biopsy of pulmonary lesions : a comparison of diagnostic accuracy and complication rate between automated gun biopsy and fine needle aspiration biopsy

International Nuclear Information System (INIS)

Kim, Keon Woo; Kang, Duk Sik

1998-01-01

The purpose of this study is to compare the efficacy and safety of CT-guided automated gun biopsy with those of fine needle aspiration biopsy of pulmonary lesions. Under CT guidance, we performed automated gu biopsies in 115 cases of 109 patients and fine needle aspiration biopsies in 119 cases of 108 patients with pulmonary lesions. Between the two methods, we compared the diagnostic rate, diagnostic accuracy and frequency of compilations according to the depth and diameter of pulmonary lesions. The overall diagnostic rates of automated gun biopsy and fine needle aspiration biopsy were 76.5 % (88/115) and 64.7 % (77/119) respectively. There was a significant statistical difference (p=0.048), especially in the case of malignant lesions less than 3 cm (p=0.027) and more than 6 cm in maximal diameter (p=0.008), and in the lesions located from 1 cm to less than 3 cm from the pleural (p=0.030), as seen on CT. There was no significant statistical difference in the frequency of complications. Automated gun biopsy of pulmonary lesions under CT guidance is safe, with complications rate comparable to those of fine needle aspiration biopsy. A higher overall diagnostic rate can be achieved by automated gun biopsy than by fine needle aspiration biopsy. For the diagnosis of pulmonary lesions under CT guidance, automated gun biopsy is therefore a more useful procedure than fine needle aspiration biopsy. (author). 24 refs., 3 tabs

A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis.

Directory of Open Access Journals (Sweden)

Yasaman Taslimi

2017-07-01

Full Text Available Accurate diagnosis of cutaneous leishmaniasis (CL is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

Diagnostic pitfalls in newborns and babies with blisters and erosions.

Science.gov (United States)

Nischler, Elke; Klausegger, Alfred; Hüttner, Clemens; Pohla-Gubo, Gabriele; Diem, Anja; Bauer, Johann W; Hintner, Helmut

2009-01-01

Establishing the correct diagnosis in newborns presenting with blisters and erosions is not always a straightforward process. Many different disease entities including acquired (i.e., infectious, immunobullous, traumatic) and inherited disorders have to be taken into consideration. Similarities in clinical appearance, colonization and/or superinfections of preexisting skin lesions, as well as the absence of late changes in the neonate often pose significant diagnostic challenges. In this paper we discuss by giving examples the process of making an accurate diagnosis of blistering skin diseases in the neonatal period on the basis of a diagnostic algorithm. In addition, we provide an overview of the rational use and the limitations of laboratory procedures such as microbial testing, routine light microscopy, immunofluorescence antigen mapping, transmission electron microscopy, and molecular genetic analysis.

Diagnostic Pitfalls in Newborns and Babies with Blisters and Erosions

Directory of Open Access Journals (Sweden)

Elke Nischler

2009-01-01

Full Text Available Establishing the correct diagnosis in newborns presenting with blisters and erosions is not always a straightforward process. Many different disease entities including acquired (i.e., infectious, immunobullous, traumatic and inherited disorders have to be taken into consideration. Similarities in clinical appearance, colonization and/or superinfections of preexisting skin lesions, as well as the absence of late changes in the neonate often pose significant diagnostic challenges. In this paper we discuss by giving examples the process of making an accurate diagnosis of blistering skin diseases in the neonatal period on the basis of a diagnostic algorithm. In addition, we provide an overview of the rational use and the limitations of laboratory procedures such as microbial testing, routine light microscopy, immunofluorescence antigen mapping, transmission electron microscopy, and molecular genetic analysis.

Persistent Skin Reactions and Aluminium Hypersensitivity Induced by Childhood Vaccines.

Science.gov (United States)

Salik, Elaha; Løvik, Ida; Andersen, Klaus E; Bygum, Anette

2016-11-02

There is increasing awareness of reactions to vaccination that include persistent skin reactions. We present here a retrospective investigation of long-lasting skin reactions and aluminium hypersensitivity in children, based on medical records and questionnaires sent to the parents. In the 10-year period 2003 to 2013 we identified 47 children with persistent skin reactions caused by childhood vaccinations. Most patients had a typical presentation of persisting pruritic subcutaneous nodules. Five children had a complex diagnostic process involving paediatricians, orthopaedics and plastic surgeons. Two patients had skin biopsies performed from their skin lesions, and 2 patients had the nodules surgically removed. Forty-two children had a patch-test performed with 2% aluminium chloride hexahydrate in petrolatum and 39 of them (92%) had a positive reaction. The persistent skin reactions were treated with potent topical corticosteroids and disappeared slowly. Although we advised families to continue vaccination of their children, one-third of parents omitted or postponed further vaccinations.

FNAC as Preoperative Diagnostic Tool for Neoplastic and Non-Neoplastic Breast Lesions: A Teaching Hospital Experience

OpenAIRE

Palak Modi; Haren Oza; Jignasa Bhalodia

2014-01-01

"Aims and objectives: Fine needle aspiration cytology is a quick, simple and accurate method for diagnosing different breast lesions. To study the role of FNAC as alternative to open surgical biopsy and accordingly to decide management of breast lump and also to study various cyto morphological patterns of breast lesions and compared them with histopathological examination, to determine the diagnostic accuracy of cytology. Materials and methods: 293 cases of palpable breast lump patie...

Percutaneous fine needle aspiration biopsy for the intrathoracic lesions: What is the meaning of non-diagnostic results?

International Nuclear Information System (INIS)

Kim, Min Ju; Lee, Jin Seong; Do, Kyung Hyun; Seo, Joon Beom; Song, Koun Sik; Lim, Tae Hwan

2003-01-01

To know what is the meaning of non-diagnostic results of fine needle aspiration biopsy (FNAB) and whether repeated aspiration is needed or not in those situations. We reviewed 1845 patients who underwent FNAB from 1997 to 2001. Non-diagnostic results of the first FNAB were divided into four groups: insufficient number of cells, inflammatory cells, necrotic debris and atypical cells. We analyzed final diagnosis of 531 patients who had non-diagnostic results from the first FNAB. Among them, 207 lesions were re-biopsied because of clinical and radiologic suspicion of malignancy. The diagnostic yield of repeated FNAB was analyzed and compared with the results of the first FNAB. Among 255 cases with 'inflammatory cells only' results, 120 cases were confirmed benignancy on follow-up. Twenty nine of 50 stypical cells (58%) were malignant of follow-up. One hundred one of 207 repeated FNAB resulted in the non-diagnostic reports, and 106 of 207 repeated FNAB were diagnosed as specific diagnosis. Among thirty lesions showing atypical cells on the repeated FNAB, 22 (73%) were identified as malignant neoplasms. When the specimen of FNAB shows atypical cells, the possibility of malignancy is very high. When the results of FNAB is non-diagnostic in the cases with clinical and radiological suspicion of malignancy, repeated FNAB procedures should be seriously considered and will be helpful for accurate specific diagnosis

A cross sectional study of anemia and iron deficiency as risk factors for arsenic-induced skin lesions in Bangladeshi women

Directory of Open Access Journals (Sweden)

Molly L. Kile

2016-02-01

Full Text Available Abstract Background In the Ganges Delta, chronic arsenic poisoning is a health concern affecting millions of people who rely on groundwater as their potable water source. The prevalence of anemia is also high in this region, particularly among women. Moreover, arsenic is known to affect heme synthesis and erythrocytes and the risk of arsenic-induced skin lesions appears to differ by sex. Methods We conducted a case-control study in 147 arsenic-exposed Bangladeshi women to assess the association between anemia and arsenic-induced skin lesions. Results We observed that the odds of arsenic-related skin lesions were approximately three times higher among women who were anemic (hemoglobin < 120 g/L compared to women with normal hemoglobin levels [Odds Ratio (OR = 3.32, 95 % Confidence Intervals (CI: 1.29, 8.52] after adjusting for arsenic levels in drinking water and other covariates. Furthermore, 75 % of the women with anemia had adequate iron stores (serum ferritin ≥12 μg/L, suggesting that the majority of anemia detected in this population was unrelated to iron depletion. Conclusions Considering the magnitude of arsenic exposure and prevalence of anemia in Bangladeshi women, additional research is warranted that identifies the causes of anemia so that effective interventions can be implemented while arsenic remediation efforts continue.

A Comparative Study on Diagnostic Accuracy of Colour Coded Digital Images, Direct Digital Images and Conventional Radiographs for Periapical Lesions – An In Vitro Study

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Mubeen; K.R., Vijayalakshmi; Bhuyan, Sanat Kumar; Panigrahi, Rajat G; Priyadarshini, Smita R; Misra, Satyaranjan; Singh, Chandravir

2014-01-01

Objectives: The identification and radiographic interpretation of periapical bone lesions is important for accurate diagnosis and treatment. The present study was undertaken to study the feasibility and diagnostic accuracy of colour coded digital radiographs in terms of presence and size of lesion and to compare the diagnostic accuracy of colour coded digital images with direct digital images and conventional radiographs for assessing periapical lesions. Materials and Methods: Sixty human dry cadaver hemimandibles were obtained and periapical lesions were created in first and second premolar teeth at the junction of cancellous and cortical bone using a micromotor handpiece and carbide burs of sizes 2, 4 and 6. After each successive use of round burs, a conventional, RVG and colour coded image was taken for each specimen. All the images were evaluated by three observers. The diagnostic accuracy for each bur and image mode was calculated statistically. Results: Our results showed good interobserver (kappa > 0.61) agreement for the different radiographic techniques and for the different bur sizes. Conventional Radiography outperformed Digital Radiography in diagnosing periapical lesions made with Size two bur. Both were equally diagnostic for lesions made with larger bur sizes. Colour coding method was least accurate among all the techniques. Conclusion: Conventional radiography traditionally forms the backbone in the diagnosis, treatment planning and follow-up of periapical lesions. Direct digital imaging is an efficient technique, in diagnostic sense. Colour coding of digital radiography was feasible but less accurate however, this imaging technique, like any other, needs to be studied continuously with the emphasis on safety of patients and diagnostic quality of images. PMID:25584318

Cryotherapy - skin

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Cryosurgery - skin; Warts - freezing; Warts - cryotherapy; Actinic keratosis - cryotherapy; Solar keratosis - cryotherapy ... may be used to: Remove warts Destroy precancerous skin lesions (actinic keratoses or solar keratoses) In rare ...

The diagnostic and prognostic implications of silver-binding nucleolar organizer regions in periodontal lesions

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Saluja Mini

2008-01-01

Full Text Available Background: The periodontal lesions with cellular proliferation can be assessed by various methods. One of the most recent methods to determine the proliferative activity is silver-staining nucleolar organizer region (AgNOR staining. The purpose of the present study was to evaluate, if AgNOR count can act as a proliferative marker and can aid in the diagnosis and prognosis of periodontal lesions. Materials and Methods: For this study, subjects with healthy gingival status, non-neoplastic lesions, neoplastic lesions, and plaque-induced gingivitis were included. Following the provisional diagnosis of clinical entity, biopsies were taken from the respective selected sites for histopathological diagnosis. In plaque-induced gingivitis cases, a second biopsy was taken from the selected sites 3 weeks following scaling. After histological confirmation, one more section was prepared, which was subjected to AgNOR staining, and AgNOR numbers were counted by individual and cluster counts and statistically analyzed. Results: Results showed the highest AgNOR count in neoplastic lesions. Non-neoplastic lesions showed a higher AgNOR count as compared to clinically healthy gingiva. Plaque-induced gingivitis showed a considerable reduction in AgNOR count after treatment. Conclusion: Results of this study confirmed that AgNOR count reflects the cellular proliferation and has a limited diagnostic value. However, the prognostic value of AgNOR for periodontal lesions is dependable.

Skin Peeling Syndrome

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Sharma Rajeev

2000-01-01

Full Text Available Peeling of the skin is an uncommonly encountered disorder. Occurrence of vesicles and bullae in peeling skin syndrome is very rare. We report a case of idiopathic peeling skin syndrome with vesicular lesions.

An evaluation of the diagnostic value of different skin tests with egg in clinically egg-allergic children having atopic dermatitis

DEFF Research Database (Denmark)

Hansen, Tine K; Høst, Arne; Bindslev-Jensen, Carsten

2004-01-01

Skin testing is a common diagnostic procedure in food allergy, but the final diagnosis of food allergy is based on the clinical response to food challenge. We studied the value of the skin prick-prick test (SPT), skin application food test (SAFT) and atopy patch test (APT) with fresh egg extract......-allergic children were positive in SPT and 40-60% in APT. In APT and in SPT false-positive reactions to egg were observed. In this study comprising a small number of patients including control subjects, neither SAFT nor APT with fresh whole egg extract were able to increase the diagnostic accuracy in detecting egg...

Diagnostic approaches in unsuspected oral lesions of syphilis.

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Siqueira, C S; Saturno, J L; de Sousa, S C O M; da Silveira, F R X

2014-12-01

Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Reliability of a Skin Diagnostic Device in Assessing Hydration and Erythema.

Science.gov (United States)

Huimin, Koh; Rowledge, Alexandra M; Borzdynski, Caroline J; Miller, Charne; Frescos, Nicoletta; McKenzie, Gayle; Perry, Elizabeth; McGuiness, William

2017-10-01

To examine the reliability of a skin diagnostic device, the SD202 (Courage+Khazaka GmBH, Cologne, Germany), in assessing hydration and erythema of periwound skin and pressure injury-prone areas. Intrarater reliabilities from 3 cross-sectional and prospective studies are reported. Patients attending an outpatient, nurse-led wound dressing clinic (n = 16), a podiatrist-led high-risk foot clinic (n = 17), and residents (n = 38) at a single residential aged-care facility. Skin hydration and erythema levels assessed using the SD202. High internal consistency was maintained for consecutive skin hydration and erythema measures at a single point on the venous leg ulcer periwound (α > .996 and α > .970 for hydration and erythema, respectively) and for the pressure-prone areas of the sacrum (α > .916), right (α > .994) and left (α > .967) ischium, right (α > .989) and left (α > .916) trochanter, right (α > .985) and left (α > .992) calcaneus, and right (α > .991) and left (α > .990) lateral malleolus. High consistency was also found for the measures obtained at 4 different locations around the periwound for the venous leg ulcer (α > .935 and α > .870 for hydration and erythema, respectively). In diabetic foot ulcer assessment, acceptable internal consistency of hydration measures around the periwound was observed (α > .634). Internal consistency of erythema measures was variable, ranging from low to high reliability, particularly among predebridement measures. Using the protocols outlined in this study, the SD202 demonstrates high reliability for assessing skin hydration and erythema levels. It is possible that the SD202 can be used in clinical practice as an appropriate tool for skin hydration and erythema assessment.

Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

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Jomhori P

2001-09-01

Full Text Available Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam, chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent, no abnormal finding was detected. Five patients (6.66 percent had atopy. In the remaining 27 patients (36 percent, the following abnormalities were found: Iron deficiency in 6 patients (8 percent, diabetes mellitus in 6 patients (8 percent, hyperthyroidism in 4 patients (5.33 percent, hypothyroidism in 2 patients (2.66 percent, lymphoma in 3 patients (4 percent, chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent. Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

In vivo assessment of optical properties of melanocytic skin lesions and differentiation of melanoma from non-malignant lesions by high-definition optical coherence tomography

DEFF Research Database (Denmark)

Boone, M A L M; Suppa, M; Dhaenens, F.

2016-01-01

One of the most challenging problems in clinical dermatology is the early detection of melanoma. Reflectance confocal microscopy (RCM) is an added tool to dermoscopy improving considerably diagnostic accuracy. However, diagnosis strongly depends on the experience of physicians. High-definition op......One of the most challenging problems in clinical dermatology is the early detection of melanoma. Reflectance confocal microscopy (RCM) is an added tool to dermoscopy improving considerably diagnostic accuracy. However, diagnosis strongly depends on the experience of physicians. High......-definition optical coherence tomography (HD-OCT) appears to offer additional structural and cellular information on melanocytic lesions complementary to that of RCM. However, the diagnostic potential of HD-OCT seems to be not high enough for ruling out the diagnosis of melanoma if based on morphology analysis...

MR imaging manifestations of skin tumors

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Kim, Jeong-hyon; Kim, Jee Young [The Catholic University of Korea, Department of Diagnostic Radiology, St. Vincent' s Hospital, Suwon, Gyeonggi-do (Korea); Chun, Kyung Ah [The Catholic University of Korea, Department of Diagnostic Radiology, Uijeongbu St. Mary Hospital, Uijeongbu, Gyeonggi-do (Korea); Jee, Won-Hee [The Catholic University of Korea, Department of Diagnostic Radiology, Kangnam St. Mary' s Hospital, Seoul (Korea); Sung, Mi-Sook [The Catholic University of Korea, Department of Diagnostic Radiology, Holy family Hospital, Bucheon, Gyeonggi-do (Korea)

2008-11-15

In this study, we evaluated MR imaging findings of skin tumors and categorized them into four types: (1) discrete mass lesions of the dermis and epidermis, (2) mass lesions of the subcutis with or without abutment to the skin, (3) diffuse or localized skin thickening without a true mass, and (4) a skin mass with bone destruction. The categorization of MR images may be useful in the differential diagnosis of skin tumors. (orig.)

Diagnostic impact of digital tomosynthesis in oncologic patients with suspected pulmonary lesions on chest radiography.

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Quaia, Emilio; Baratella, Elisa; Poillucci, Gabriele; Gennari, Antonio Giulio; Cova, Maria Assunta

2016-08-01

To assess the actual diagnostic impact of digital tomosynthesis (DTS) in oncologic patients with suspected pulmonary lesions on chest radiography (CXR). A total of 237 patients (135 male, 102 female; age, 70.8 ± 10.4 years) with a known primary malignancy and suspected pulmonary lesion(s) on CXR and who underwent DTS were retrospectively identified. Two radiologists (experience, 10 and 15 years) analysed in consensus CXR and DTS images and proposed a diagnosis according to a confidence score: 1 or 2 = definitely or probably benign pulmonary or extrapulmonary lesion, or pseudolesion; 3 = indeterminate; 4 or 5 = probably or definitely pulmonary lesion. DTS findings were proven by CT (n = 114 patients), CXR during follow-up (n = 105) or histology (n = 18). Final diagnoses included 77 pulmonary opacities, 26 pulmonary scars, 12 pleural lesions and 122 pulmonary pseudolesions. DTS vs CXR presented a higher (P chest radiography (CXR) in oncologic patients. • DTS improves confidence of CXR in oncologic patients. • DTS allowed avoidance of CT in about 50 % of oncologic patients.

Angiosonography in suspicious breast lesions with non-diagnostic FNAC: comparison with power Doppler US.

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Caumo, F; Carbognin, G; Casarin, A; Pinali, L; Vasori, S; D'Onofrio, M; Pozzi Mucelli, R

2006-02-01

The purpose of this study was to evaluate the accuracy of angiosonography in comparison with colour Doppler ultrasound (US) in the discrimination of suspicious breast lesions with nondiagnostic fine-needle aspiration cytology (FNAC). Pre-operative Power Doppler US and angiosonography were prospectively performed in 20 suspicious breast lesions with non-diagnostic FNAC. A second-generation US contrast agent was utilised with a high-frequency transducer and a contrast-specific algorithm (low acoustic pressure CnTI). The enhancement characteristics of all lesions were analysed using qualitative and quantitative parameters obtained from time-intensity curves with the different imaging modalities. The final diagnosis was confirmed at pathology in all cases. Microvessel density (MVD) was assessed in the surgical specimen using CD34. The correct assessment of biological behaviour was achieved in all cases by angiosonography (sensitivity of 100%; specificity of 91%) and colour Doppler US (45% sensitivity; 78% specificity). MVD correlated with the biological behaviour. Angiosonography is more accurate than colour Doppler US in the correct assessment of biological behaviour of suspicious breast lesions.

Inactive fibrotic lesions versus pulmonary tuberculosis with negative bacteriology.

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Solsona Peiró, Jordi; de Souza Galvão, Maria Luiza; Altet Gómez, Maria Neus

2014-11-01

This article analyzes the concept of inactive fibrotic lesions of presumed tuberculous origin (old healed tuberculosis), defined by radiological characteristics and a positive tuberculin skin test (TST), and we examine the evidence-based foundation for the indication of treatment of latent tuberculosis infection in these cases. We explore the risk of reactivation in older and recent literature, and the problems raised by the differential diagnosis with active tuberculosis with negative bacteriology. We also analyze data on the prevalence of fibrotic lesions in the recent literature. We examine the possible role of Interferon Gamma Release Assays (IGRAs) versus TST and other molecular antigen detection techniques in sputum that can aid in establishing the diagnosis and we discuss the current indications for chemoprophylaxis and the different options available. We propose diagnostic guidelines and therapeutic algorithms based on risk stratification by age and other factors in the management of radiological lesions that raise a differential diagnosis between fibrotic lesions and active pulmonary tuberculosis with negative bacteriology. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Immunohistochemical expression of perforin in lichen planus lesions.

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Gaber, Mohamed Abdelwahed; Maraee, Alaa Hassan; Alsheraky, Dalia Rifaat; Azeem, Marwa Hussain Abdel

2014-12-01

Lichen planus (LP) is a chronic inflammatory papulosquamous skin disease characterized by epidermal basal cell damage and a particular band-like infiltrate predominantly of T cells in the upper dermis. It is characterized by the formation of colloid bodies representing apoptotic keratinocytes. The apoptotic process mediated by CD8+ cytotoxic T lymphocytes and natural killer cells mainly involves two distinct pathways: the perforin/granzyme pathway and the Fas/FasL pathway. So far, little is known regarding the role of perforin-mediated apoptosis in LP. Is to study the expression and distribution of perforin in the epidermis and dermis of lesional LP skin. Skin biopsy specimens from lesional skin of 31 patients with LP and 10 healthy persons were analyzed by immunohistochemistry. Significant accumulation of perforin + cells was found in both epidermis and dermis of LP lesions compared with healthy skin. Perforin expression was significantly upregulated in the epidermis of LP lesions. Accumulation of perforin + cells in the epidermis of LP lesions suggest a potential role of perforin in the apoptosis of basal keratinocytes.

Skin Lesions Associated with Nutritional Management of Maple Syrup Urine Disease

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Jaraspong Uaariyapanichkul

2017-01-01

Full Text Available Introduction. Maple syrup urine disease (MSUD is an inborn error of branched chain amino acids (BCAAs metabolism. We report an infant with MSUD who developed 2 episodes of cutaneous lesions as a result of isoleucine deficiency and zinc deficiency, respectively. Case Presentation. A 12-day-old male infant was presented with poor milk intake and lethargy. The diagnosis of MSUD was made based on clinical and biochemical data. Management and Outcome. Specific dietary restriction of BCAAs was given. Subsequently, natural protein was stopped as the patient developed hospital-acquired infections which resulted in an elevation of BCAAs. Acrodermatitis dysmetabolica developed and was confirmed to be from isoleucine deficiency. At the age of 6 months, the patient developed severe lethargy and was on natural protein exclusion for an extended period. Despite enteral supplementation of zinc sulfate, cutaneous manifestations due to zinc deficiency occurred. Discussion. Skin lesions in MSUD patients could arise from multiple causes. Nutritional deficiency including isoleucine and zinc deficiencies can occur and could complicate the treatment course as a result of malabsorption, even while on enteral supplementation. Parenteral nutrition should be considered and initiated accordingly. Clinical status, as well as BCAA levels, should be closely monitored in MSUD patients.

Clinical diagnostic study by means of magnetic resonance imaging for lesions of the major salivary gland region

International Nuclear Information System (INIS)

Iihama, Tsuyoshi; Mataga, Izumi; Kato, Joji

1994-01-01

The diagnostic value of magnetic resonance imaging (MRI) for lesions situated in the major salivary glands was clinically discussed in this study. A total of 46 patients with salivary gland disorders treated in our department over the past five years were assessed by mean of MRI, and in 11 patients the findings were compared with the histopathological features of lesions sectioned at the same level postoperatively. In addition, preliminary investigations to introduce a new qualitative diagnostic procedure for estimation of salivary gland function in geriatric patients were attempted. In this investigation, T 1 and T 2 values, and signal intensity ratios of the submandibular gland were measured in elderly patients complaining of dry mouth and in healthy controls. Likewise, salivary gland function was examined by taste stimulation induced by applying citric acid to the tongue surface just before starting MRI. MRI clearly demonstrated lesions in the salivary glands. The histopathological diagnosis could not be accurately predicted by signal intensity. However, benign tumors showed higher intensity signals than did malignant tumors on T 2 -weighted images. Cystic lesions could be differentiated from tumors by signal intensity. Histopathological features of salivary gland tumors corresponded to the MRI signal intensity. Relaxation times of T 1 and T 2 values and signal intensity in each major salivary gland were diminished in elderly patients in a resting condition. Only T 1 values in healthy subjects remarkably responded to taste stimulation. These results suggest that MRI is useful and beneficial not only in the qualitative diagnosis of tumors arising from salivary glands but also in the estimation of salivary gland function. MRI should therefore be included in routine diagnostic examinations for salivary gland disorders. (author)

Image-guided automated needle biopsy of 106 thoracic lesions: a retrospective review of diagnostic accuracy and complication rates

International Nuclear Information System (INIS)

Connor, S.; Dyer, J.; Guest, P.

2000-01-01

We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98 %) biopsies. There were 75 of 85 (88 %) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70 of 85 (82 %) cases. A specific histological diagnosis was obtained in 12 of 18 (66 %) biopsies. There was a 19 % rate of pneumothorax with only 2.4 % requiring drainage. Minor haemoptysis occurred in 3.8 % of procedures. The TNB technique with an automated core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication rate compared with FNA. (orig.)

AIDS-Related Endemic Mycoses in Western Cape, South Africa, and Clinical Mimics: A Cross-Sectional Study of Adults With Advanced HIV and Recent-Onset, Widespread Skin Lesions

Science.gov (United States)

Kenyon, Chris; Lehloenya, Rannakoe; Claasens, Saskya; Spengane, Zandile; Prozesky, Hans; Burton, Rosie; Parker, Arifa; Wasserman, Sean; Meintjes, Graeme; Mendelson, Marc; Taljaard, Jantjie; Schneider, Johann W; Beylis, Natalie; Maloba, Bonnie; Govender, Nelesh P; Colebunders, Robert; Dlamini, Sipho

2017-01-01

Abstract Background Skin lesions are common in advanced HIV infection and are sometimes caused by serious diseases like systemic mycoses (SM). AIDS-related SM endemic to Western Cape, South Africa, include emergomycosis (formerly disseminated emmonsiosis), histoplasmosis, and sporotrichosis. We previously reported that 95% of patients with AIDS-related emergomycosis had skin lesions, although these were frequently overlooked or misdiagnosed clinically. Prospective studies are needed to characterize skin lesions of SM in South Africa and to help distinguish these from common HIV-related dermatoses. Methods We prospectively enrolled HIV-infected adult patients living in Western Cape, South Africa, with CD4 counts ≤100 cells/μL and widespread skin lesions present ≤6 months that were deemed clinically compatible with SM. We obtained skin biopsies for histopathology and fungal culture and collected epidemiological and clinical data. Results Of 34 patients enrolled and in whom a diagnosis could be made, 25 had proven SM: 14 had emergomycosis, and 3 each had histoplasmosis and sporotrichosis; for 5 additional patients, the fungal species could not be identified. Antiretroviral therapy (ART) had been initiated in the preceding 4 weeks for 11/25 (44%) patients with SM (vs no patients without SM). Plaques and scale crust occurred more frequently in patients with SM (96% vs 25%, P = .0002; and 67% vs 13%, P = .01, respectively). Conclusions Recent ART initiation and presence of plaques or scale crust should make clinicians consider SM in patients with advanced HIV infection in this geographic area. Clinical overlap between SM and other dermatoses makes early skin biopsy critical for timely diagnosis and treatment. PMID:29164168

Diagnostic Pitfalls in Newborns and Babies with Blisters and Erosions

OpenAIRE

Elke Nischler; Alfred Klausegger; Clemens Hüttner; Gabriele Pohla-Gubo; Anja Diem; Johann W. Bauer; Helmut Hintner

2009-01-01

Establishing the correct diagnosis in newborns presenting with blisters and erosions is not always a straightforward process. Many different disease entities including acquired (i.e., infectious, immunobullous, traumatic) and inherited disorders have to be taken into consideration. Similarities in clinical appearance, colonization and/or superinfections of preexisting skin lesions, as well as the absence of late changes in the neonate often pose significant diagnostic challenges. In this pape...

An exploratory study demonstrating the diagnostic ability of healthcare professionals in primary care using online case studies for common skin conditions.

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Tucker, Rod; Patel, Mahendra; Layton, Alison L; Walton, Shernaz

2014-04-01

To compare the diagnostic ability of pharmacists, nurses and general practitioners (GPs) for a range of skin conditions. An online study comprising 10 specifically developed dermatological case studies containing a digital image of the skin condition and a short case history. A total of 60 participants (20 representing each of pharmacists, GPs and primary care nurses) were required to identify the skin condition as well as the features in the case history that supported the diagnosis and the recommended first-line management approach for the condition. The mean diagnostic scores for each group were GPs = 8.8 (95% confidence interval, CI, 7.9-9.6), pharmacists = 6.2 (95% CI, 5.4-6.9) and nurses = 7.0 (95% CI, 6.1-7.9). Post hoc analysis revealed that the difference in mean diagnostic scores was significant (P skin conditions such as tinea corporis, scabies and plantar warts and overall at least 40% of pharmacists correctly identified all conditions. This small study has demonstrated that for all of the skin conditions considered, pharmacists' overall diagnostic scores were significantly different from those of GPs but similar to those of nurses for the conditions assessed. However, further work with a larger sample is required to determine the accuracy of these preliminary findings and to establish whether advice given by pharmacists in practice results in the appropriate course of action being taken. © 2013 Royal Pharmaceutical Society.

A novel papillomavirus isolated from proliferative skin lesions of a wild American beaver (Castor canadensis).

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Rogovskyy, Artem S; Baszler, Timothy V; Bradway, Daniel S; Bruning, Darren L; Davitt, Christine M; Evermann, James F; Burk, Robert D; Chen, Zigui; Mansfield, Kristin G; Haldorson, Gary J

2012-07-01

Cutaneous papillomatosis was diagnosed in an adult American beaver (Castor canadensis). Gross lesions included numerous exophytic, roughly circular, lightly pigmented lesions on hairless areas of fore and hind feet and the nose. The most significant histopathologic findings were multifocal papilliform hyperplasia of the superficial stratified squamous epithelium, with multifocal koilocytes, and multiple cells with large, darkly basophilic intranuclear inclusion bodies. A virus with properties consistent with papillomavirus (PV) was recovered by virus isolation of skin lesions, utilizing rabbit and feline kidney cell lines. The presence of the virus was confirmed by PV-specific polymerase chain reaction. The partial sequences of E1 and L1 genes did not closely match those of any PVs in GenBank, suggesting that this might be a new type of PV. Partial E1 and L1 nucleotide sequences of the beaver papillomavirus (hereafter, ARbeaver-PV1) were used to create a phylogenetic tree employing the complete E1 and L1 open reading frame nucleotide sequences of 68 PVs. The phylogenetic tree placed the ARbeaver-PV1 in a clade that included the Mupapillomavirus (HPV1 and HPV63) and Kappapapillomavirus (OcPV1 and SfPV1) genera. The present article confirms the papillomaviral etiology of cutaneous exophytic lesions in the beaver.

Skin Cancer Screening

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... Genetics of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? ... These are called diagnostic tests . General Information About Skin Cancer Key Points Skin cancer is a disease ...

In vivo pump-probe microscopy of melanoma and pigmented lesions

Science.gov (United States)

Wilson, Jesse W.; Degan, Simone; Mitropoulos, Tanya; Selim, M. Angelica; Zhang, Jennifer Y.; Warren, Warren S.

2012-03-01

A growing number of dermatologists and pathologists are concerned that the rapidly rising incidence of melanoma reflects not a true 'epidemic' but an increasing tendency to overdiagnose pigmented lesions. Addressing this problem requires both a better understanding of early-stage melanoma and new diagnostic criteria based on more than just cellular morphology and architecture. Here we present a method for in-vivo optical microscopy that utilizes pump-probe spectroscopy to image the distribution of the two forms of melanin in skin: eumelanin and pheomelanin. Images are acquired in a scanning microscope with a sensitive modulation transfer technique by analyzing back-scattered probe light with a lock-in amplifier. Early-stage melanoma is studied in a human skin xenografted mouse model. Individual melanocytes have been observed, in addition to pigmented keratinocytes. Combining the pump-probe images simultaneously with other noninvasive laser microscopy methods (confocal reflectance, multiphoton autofluorescence, and second harmonic generation) allows visualization of the skin architecture, framing the functional pump-probe image in the context of the surrounding tissue morphology. It is found that pump-probe images of melanin can be acquired with low peak intensities, enabling wide field-of-view pigmentation surveys. Finally, we investigate the diagnostic potential of the additional chemical information available from pump-probe microscopy.

Skin pathology in Hawaiian goldring surgeonfish, Ctenochaetus strigosus (Bennett)

Science.gov (United States)

Work, Thierry M.; Aeby, Greta S.

2014-01-01

Twenty-eight goldring surgeonfish, Ctenochaetus strigosus (Bennett), manifesting skin lesions and originating from the north-western and main Hawaiian Islands were examined. Skin lesions were amorphous and ranged from simple dark or light discolouration to multicoloured tan to white sessile masses with an undulant surface. Skin lesions covered 2–66% of the fish surface, and there was no predilection for lesions affecting a particular part of the fish. Males appeared over-represented. Microscopy revealed the skin lesions to be hyperplasia, melanophoromas or iridophoromas. The presence of skin tumours in a relatively unspoiled area of Hawaii is intriguing. Explaining their distribution, cause and impact on survivorship of fish all merit further study because C. strigosus is an economically important fish in the region.

Changes in diagnostic methods of non-palpable breast lesions: analysis for 5 years

International Nuclear Information System (INIS)

Kim, Eun Kyung; Oh, Ki Keun; Kim, Mi Hye; You, Jai Kyung; Kwak, Jin Young; Park, Byeong Woo; Lee, Kyong Sik

2002-01-01

To describe the changes in diagnostic methods and reassess the role of core biopsy compared with needle localization biopsy (NLB) in the evaluation of non-palpable breast lesions. We retrospectively analyzed 930 non-palpable breast lesions which underwent either core biopsy or NLB between January 1996 and December 2000. NLB involved 511 lesions in 482 patients, and core 419 lesions in 365 patients. For a given lesion, NLB was guided by either mammography (n=213) or ultrasonography (US) (n=298), but only US was used to guide a core biopsy. Over the five-year period, we calculated the total number of biopsies per year relating to non-palpable breast lesions, also determining the mammographic findings in cases involving NLB and the percentage of malignancies seen at histopathology. The total number of biopsies increased with time: 1996: n=91, 1997: n=118, 1998: n=144, 1999: n=245, 2000: n=332. The implementation of core biopsy, however, led to a decrease in the proportion of NLB (1996: 97.8%, 1997:84.7%, 1998: 75.7%, 1999: 47.8%, 2000: 28.9%). Among nonpalpable lesions which underwent mammgraphy-guided MLB, 46.5% (20/43) were a mass or density in 1996, while in 2000 the proportion was 5.7% (2/35). During this period, however, the finding of calcification without a mass increased from 48.8% in 1996 to 94.3% in 2000. The proportion of cases in which NLB demonstrated malignancy increased from 13.5% in 1996 to 49% in 2000; where US-guided NLB was used, the increase was remarkable: from 15.2% in 1996 to 65.6% in 2000. In the evaluation of non-palpable breast lesions, the appropriate use of core biopsy can decrease the need for a more invasive method such as NLB. Furthermore, because most benign lesions diagnosed by core biopsy do not also undergo NLB, the use of the latter increases the yield of malignancies

Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence

Science.gov (United States)

2012-01-01

Background Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer services in many healthcare systems. The majority of such physicians receive very limited formal undergraduate or postgraduate dermatology training. The British Association of Dermatologists (BAD) has produced guidelines that list the lesions that students should be able to diagnose on graduation and the majority of UK medical schools’ operate curricula in keeping with these. There is, however, virtually no evidence as to whether these competencies are being achieved. We set out to determine students’ competence at skin lesion diagnosis and to quantify their clinical exposure to examples of such lesions during their dermatology attachment. Methods Three linked studies were undertaken. In the first, students’ competence was tested by randomized slideshows of images containing the 16 lesions recommended in the UK guidelines. Students’ accuracy was tested at the beginning (Day 1) and end (Day 10) of their clinical placement, with a random sample of students retested 12 months later. Secondly, students’ exposure to these lesions was recorded during their attachments. Finally a survey of the additional dermatological resources used by the students was undertaken. Results Study 1: Students’ diagnostic accuracy increased from 11% on Day 1 to 33% on Day 10 (effect size +2.72). After 12 months half of this effect had disappeared and the students accuracy had dropped to 24%. Study 2: Students’ exposure to the recommended lesions was poor with 82% not even witnessing a single example of each of the 3 major skin cancers. Despite these measurements, only a minority of students reported that they were not confident at diagnosing skin tumours. Study 3: The majority of students use additional resources to supplement their learning

Skin tags: A link between lesional mast cell count/tryptase expression and obesity and dyslipidemia

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Samar Abdallah M Salem

2013-01-01

Full Text Available Background:The etiology of skin tags (STs is not fully understood. A relation to diabetes mellitus and obesity was suggested. Few studies of possible mast cells (MCs involvement were reported. Tyrptase is a mast cell mediator and a potent fibroblast growth factor. It may provide a molecular link between mast cell activation and fibrosis. Aims: The aim was to assess clinical and laboratory findings in patients with STs, and the possible link between obesity, dyslipidemia, and lesional MC count/tryptase expression. Materials and Methods: A total of 20 patients with STs were subjected to clinical examination, estimation of body mass index (BMI, fasting blood glucose (FBG, postprandial blood glucose (PPBG, serum cholesterol and triglycerides, abdominal ultrasound for fatty liver assessment, in addition to study of MCs through staining for MC tryptase in two skin biopsies; lesional and nonlesional (control. Results:All patients showed abnormally high BMI and hypertriglyceridemia, with abnormal sonographic pattern in 15 patients (75%. STs number positively correlated with the age of patients. STs showed significantly higher MC counts and tryptase expression, compared with control skin ( P < 0.001, with no correlation of the STs number or MC count with BMI, FBG, PPBG or serum cholesterol. Obese patients showed a significantly higher MC count than overweight and there was a positive correlation between MC count and serum triglycerides. Axilla and under breast STs showed a higher MC count compared with other sites. Conclusions:STs seem to be related to obesity and hypertriglyceridemia. MCs with their tryptase are possibly involved in pathogenesis of STs. MC count is related to the associated factors; obesity and serum triglycerides. MC tryptase expression is a reliable method for accurate tissue MC counting.

Efficiency of ablative fractional Er: YAG (Erbium: Yttrium-Aluminum-Garnet laser treatment of epidermal and dermal benign skin lesions: A retrospective study

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Erol Koç

2014-03-01

Full Text Available Background: Er: YAG lasers are precise ablation systems used in the treatment epidermal and dermal benign skin lesions. In this study, we restrospectively analysed efficiency of Er: YAG laser therapy in the treatment of epidermal and dermal benign skin lesions. Materials and Methods: We retrospectively investigated our clinical records of 116 patients treated with Er: YAG laser between April 2011 and April 2013. The clinical records of 103 patients (47 men, 56 women were included in our study. Of these 103 patients included in the study were xanthelasma, solar lentigo, epidermal nevus, seborrheic keratosis, nevus of ota, syringoma, cafe au lait macules (CALM and other than these. Treatment parameters, demographic features and before and after photographs of the lesions were investigated from patients’ records in order to evaluate efficiency of Er: YAG laser therapy. Results: Of these 103 patients included in the study were evaluated in 8 groups, described as xanthelasma (n=21, syringoma (n=17, solar lentigo (n=16, epidermal nevus (n=11, seborrheic keratosis (n=9, nevus of ota (n=5, CALM (n=3 and other than these (n=21. In the Er: YAG laser treatment, the average energy flow was 3-7 J/cm2, the average pulse duration was 300 ms, the average number of passes was 3-5 repeat, and the average pulse frequency was 3-7 Hz. While 4.9% of the patients showed no improvement, 59.2% showed marked improvement, 26.2% showed moderate improvement and 9.7% showed mild improvement. Treatment responses in xanthelasma, syringoma, epidermal nevus, solar lentigo and CALM lesions were statistically significant. Observed side effects were hyperpigmentation in 4 patients, hypopigmentation in 3 patients, hypertrophic scar in 2 patients and persistent erythema in one patient and the treatment was well tolerated by all the patients. Conclusion: Er: YAG laser is an effective and safe treatment option in the treatment of benign skin lesions especially in epidermal lesions.

Proliferative, reparative, and reactive benign bone lesions that may be confused diagnostically with true osseous neoplasms.

LENUS (Irish Health Repository)

Wick, Mark R

2014-01-01

Diagnostic problems attending intraosseous and parosteal pseudoneoplastic lesions can be radiographic, or histological, or both. Proliferations in this category may contain cellular fibro-osseous or chondro-osseous tissues that are difficult to separate microscopically from those seen in various true neoplasms of the bones. This review considers the clinicopathologic features of fibrous dysplasia, benign fibro-osseous lesions of the jawbones, osteofibrous dysplasia, metaphyseal fibrous defect, giant-cell reparative granuloma, "brown tumor" of hyperparathyroidism, synovial chondrometaplasia, aneurysmal bone cyst, tumefactive chronic osteomyelitis, proliferative Paget disease, and polyvinylpyrrolidone storage disease of bone.

Hock lesions and free-stall design.

Science.gov (United States)

Weary, D M; Taszkun, I

2000-04-01

We compared the prevalence and severity of skin lesions on the hocks of lactating dairy cows in southern British Columbia, comparing 20 farms using three common bedding surfaces: sawdust, sand, and geotextile mattresses. Skin lesions were scored at five positions on the hock. For each position we noted if the lesion showed inflammatory attributes, and then assigned a severity score. Of the 1752 lactating cows scored, 1267 cows (73%) had at least one hock lesion. Of those cows with lesions, 87% had lesions on both legs, 76% had lesions on more than one location on the hock, and 78% had a lesion of at least moderate severity (i.e., evidence of skin breakage or an area of hair loss >10 cm2). Lesions were most prevalent on farms that used geotextile mattresses (91% of cows) and least common on farms that used sand (24% of cows). Moreover, lesions on cows from farms using mattresses were more numerous and more severe than those on cows from sand-bedded farms. The prevalence and severity of lesions on farms using sawdust was intermediate. Lesions also varied in relation to location on the hock. For farms using geotextile mattresses, lesions were more common and more severe on the lateral surfaces of both the tuber calcis and the tarsal joint. On farms using sawdust, lesions were common on the dorsal surface of the tuber calcis and the lateral surfaces of both the tuber calcis and the tarsal joint. Lesions were rare on all five positions for cows from sand-bedded farms. Among the 10 farms sampled using sawdust, we found a significant negative relationship between the length of the stall and severity of lesions. For cows with lesions, the number and severity of lesions increased with age.

In vivo analysis of tissue by Raman microprobe: examination of human skin lesions and esophagus Barrett's mucosa on an animal model

Science.gov (United States)

Tfayli, Ali; Piot, Olivier; Derancourt, Sylvie; Cadiot, Guillaume; Diebold, Marie D.; Bernard, Philippe; Manfait, Michel

2006-02-01

In the last few years, Raman spectroscopy has been increasingly used for the characterization of normal and pathological tissues. A new Raman system, constituted of optic fibers bundle coupled to an axial Raman spectrometer (Horiba Jobin Yvon SAS), was developed for in vivo investigations. Here, we present in vivo analysis on two tissues: human skin and esophagus mucosa on a rat model. The skin is a directly accessible organ, representing a high diversity of lesions and cancers. Including malignant melanoma, basal cell carcinoma and the squamous cell carcinoma, skin cancer is the cancer with the highest incidence worldwide. Several Raman investigations were performed to discriminate and classify different types of skin lesions, on thin sections of biopsies. Here, we try to characterize in vivo the different types of skin cancers in order to be able to detect them in their early stages of development and to define precisely the exeresis limits. Barrett's mucosa was also studied by in vivo examination of rat's esophagus. Barrett's mucosa, induced by gastro-esophageal reflux, is a pretumoral state that has to be carefully monitored due to its high risk of evolution in adenocarcinoma. A better knowledge of the histological transformation of esophagus epithelium in a Barrett's type will lead to a more efficient detection of the pathology for its early diagnosis. To study these changes, an animal model (rats developing Barrett's mucosa after duodenum - esophagus anastomosis) was used. Potential of vibrational spectroscopy for Barrett's mucosa identification is assessed on this model.

Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

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Cindy L. Lamerson

2012-01-01

Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

Unique Presentation of Orf Virus Infection in a Thermal-Burn Patient After Receiving an Autologous Skin Graft.

Science.gov (United States)

Hsu, Christopher H; Rokni, Ghasem Rahmatpour; Aghazadeh, Nessa; Brinster, Nooshin; Li, Yu; Muehlenbachs, Atis; Goldsmith, Cynthia S; Zhao, Hui; Petersen, Brett; McCollum, Andrea M; Reynolds, Mary G

2016-10-15

We describe a burn patient who developed skin lesions on her skin-graft harvest and skin-graft recipient (burn) sites. Orf virus infection was confirmed by a combination of diagnostic assays, including molecular tests, immunohistochemical analysis, pathologic analysis, and electron microscopy. DNA sequence analysis grouped this orf virus isolate among isolates from India. Although no definitive source of infection was determined from this case, this is the first reported case of orf virus infection in a skin graft harvest. Skin graft recipients with exposures to animals may be at risk for this viral infection. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The diagnostic utility of CK5/6 and p63 in fine-needle aspiration of the breast lesions diagnosed as proliferative fibrocystic lesion.

Science.gov (United States)

Al-Maghraby, Hatem; Ghorab, Zeina; Khalbuss, Walid; Wong, John; Silverman, Jan F; Saad, Reda S

2012-02-01

Fine-needle aspiration (FNA) biopsy (FNAB) in the preoperative assessment of breast lesions has shown diagnostic limitations with false-positive and false-negative diagnoses. We investigated the diagnostic value of cytokeratin 5/6 (CK5/6) and p63 in a series of breast FNABs, diagnosed as proliferative breast lesions with or without atypia, to see whether these ancillary studies enhance the ability to make an accurate diagnosis by FNAB. Sixty-four breast FNABs were retrieved between January 2000 and December 2005 and included in the study as follows: 29/64 (45%) cases as proliferative with atypia and 35/64 (55%) without atypia. We also included 10 cases of fibroadenoma. All cases had histological follow-up available for correlation. Immunostaining for CK5/6 and p63 was performed on the cell block material in all cases. The percentage of staining cells in the specimen was graded as 0 (0-10%), 1 (11-25%), 2 (26-50%), and 3 (>50%). There were 9/29 (31%) cases in the atypical group that were found to be malignant on resection, compared with 6/35 (17%) in the cases without atypia. In histologically proven malignant cases, CK5/6 was negative in 11/15 (73%) or showed 1+ stain in 2/15 (13%) cases. In benign breast lesions, CK5/6 stained more than 25% of cell proliferation in 44/49 (90%). p63 showed characteristic staining for single naked bipolar nuclei in the background of the specimen (not appreciated by CK5/6) in all fibroadenoma cases. In conclusion, CK5/6 may enhance the ability to differentiate between benign and malignant epithelial proliferations in breast FNABs. In fibroepithelial lesions, p63 may be more useful than CK5/6. Copyright © 2010 Wiley Periodicals, Inc.

Prevention and treatment of skin lesions associated with non-invasive mechanical ventilation. Recommendations of experts.

Science.gov (United States)

Raurell-Torredà, M; Romero-Collado, A; Rodríguez-Palma, M; Farrés-Tarafa, M; Martí, J D; Hurtado-Pardos, B; Peñarrubia-San Florencio, L; Saez-Paredes, P; Esquinas, A M

In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel. Knowledge about how to measure correct mask size and protection of the skin with foam or hydrocolloids dressings are factors related to the incidence of LESADIC, as it conditions the degree of pressure-friction and shear that the interface exerts on the skin. The interface that causes fewer LESADIC and is better tolerated is the face mask. When there are injuries, the first thing is to remove the interface that causes pressure on damaged skin, recommending a Helmet ® hood as an alternative, treating the infection, managing the exudate and stimulating perilesional skin. The mask of choice is the facial, always using foam or hydrocolloid dressings on the nasal bridge. Evaluate the condition of the skin under the interface and harness every 4hours (recommended) and 11hours (maximum). Evaluate the rotation strategy of the interface at 24hours if the NIV is still needed on an ongoing basis. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

Infrared imaging of skin lesions

Science.gov (United States)

McIntosh, Laura M.; Mansfield, James R.; Jackson, Michael; Crowson, A. Neil; Mantsch, Henry H.

2002-02-01

IR spectroscopy produces spectra in which detailed information concerning chemical structure is inherent. Numerous studies have demonstrated that the most useful IR methods for analysis of biological tissues are microscopic image-based techniques in which fine-scaled spatial and high-quality spectral information is integrated. Unlike traditional visible microscopic methods, the contrast in IR imaging is gained by differences in spectra and the spatial heterogeneity of biochemical components, not by the addition of stains. In order for IR imaging to be more broadly accepted, non-subjective data processing methods are being developed to extract the most out of the large spectral images that are acquired. This paper demonstrates data processing techniques that have been extremely useful in the analysis of normal and abnormal skin. Analysis of skin specimens is of particular clinical importance due to the difficulty in rendering a differential diagnosis. Unstained frozen skin sections were mapped using an IR microscope. Functional group mapping, clustering routines and linear discriminant analysis were used to process the data. Functional group mapping and clustering routines were useful in the initial interpretation of images and to research for trends in uncharacterized spectral images. LDA was useful for differentiating normal from abnormal tissue once a well- defined training spectral set was established. Representative spectroscopic images are shown that demonstrate the power of IR imaging.

Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland

International Nuclear Information System (INIS)

Park, Soo Bin; Choi, Joon Young; Lee, Eun Jeong; Yoo, Jang; Cheon, Miju; Cho, Suk Kyong; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae

2012-01-01

We investigated PET/CT diagnostic criteria for differentiating benign from malignant parotid lesions with focal 18 F-FDG uptake. The subjects of the study were 272 patients who exhibited focal 18 F-FDG uptake of the parotid gland. Sixty-eight pathologically confirmed parotid lesions from 67 patients were included. The maximum SUV (SUVmax), uptake patterns (homogeneous vs. heterogeneous), size measured by CT, maximum Housfield units (HUmax) and margins on CT (well vs. ill defined) of each parotid lesion on PET/CT images were compared with final diagnoses. Thirty- two parotid lesions were histologically proven to be malignant. There were significant differences in uptake patterns (cancer incidence, heterogeneous:homogeneous=79.2%:29.5%, p<0.0001) and margins on CT (cancer incidence, ill:well defined=84.4%:13.3%, p<0.0001) between benign and malignant lesions. The cancer risks of parotid lesions were 89.5% with heterogeneous uptake and ill-defined margins, 70.6% with heterogeneous uptake or ill-defined margins (no overlap in subjects) and 9.3% with homogeneous uptake and well-defined margins (p<0.0001). When any lesion with heterogeneous uptake or ill-defined margins was regarded as malignant, the sensitivity, positive predictive value, negative predictive value and accuracy were 90.6% (29/32) and 85.6% (58/68), respectively. For predicting malignancy, combined PET/CT criteria showed better sensitivity, NPV and accuracy than PET-only criteria, and had a tendency to have more accurate results than CT-only criteria, and had a tendency to have more accurate results than CT-only criteria. There were no significant differences in SUVmax, size or HUmax between benign and malignant lesions. Uptake patterns and margins on CT are useful PET/CT diagnostic criteria for differentiating benign from malignant lesions

Increased number of mast cells in the dermis in actinic keratosis lesions effectively treated with imiquimod.

Science.gov (United States)

Oyama, Satomi; Funasaka, Yoko; Tsuchiya, Shin-Ichi; Kawana, Seiji; Saeki, Hidehisa

2017-08-01

Actinic keratosis (AK) is a cutaneous cancer in situ which develops as a result of excessive exposure to ultraviolet (UV). Toll-like receptor (TLR)7 agonist imiquimod is a topical immune response modifier and is effective for the treatment of non-melanoma skin cancers. Recently, the diagnostic role of the dermatoscope has been reported in the course of treatment of AK. In addition, mast cells are now considered to contribute to both the innate and adaptive immune systems in topical imiquimod therapy. We assessed the effect of imiquimod treatment by dermatoscopic and immunohistochemical findings in 14 patients with a total of 21 AK lesions. With the dermatoscope, though the mean erythema score was not significantly different between the cured lesions and the unresponsive lesions, the erythema/red pseudo-network ("strawberry") pattern was decreased significantly in the cured lesions. By immunohistochemistry, the number of Ki-67-positive proliferative cells in the epidermis was decreased and that of CD117-positive mast cells in the dermis was increased in the responding lesions. To the best of our knowledge, this is the first study demonstrating that the number of mast cells in the dermis was increased in AK lesions effectively treated with imiquimod. Our present result suggests that mast cells may contribute an antitumor effect in human skin treated with topical imiquimod. © 2017 Japanese Dermatological Association.

A Diagnostic Approach for Rodent Progressive Cardiomyopathy and Like Lesions in Toxicology Studies up to 28 Days in the Sprague Dawley Rat (Part 2 of 2).

Science.gov (United States)

Hailey, James R; Maleeff, Beverly E; Thomas, Heath C; Pearse, Gail; Klapwijk, Jan C; Cristofori, Patrizia G; Berridge, Brian; Kimbrough, Carie L; Parker, George A; Morton, Daniel; Elmore, Susan; Hardisty, Jerry F; Dybdal, Noel O; Rehagen, David A; Fikes, James D; Lamb, Martin; Biddle, Kathleen; Buetow, Bernard S; Carreira, Vinicius; Nyska, Abraham; Tripathi, Niraj K; Workman, Heather C; Bienvenu, Jean-Guy; Brees, Ingrid; Turk, James R; Adler, Rick R

2017-12-01

To test the diagnostic approach described in part 1 of this article, 2 exercises were completed by pathologists from multiple companies/agencies. Pathologist's examination of whole slide image (WSI) heart sections from rats using personal diagnostic approaches (exercise #1) corroborated conclusions from study #1. Using the diagnostic approach described in part 1, these pathologists examined the same WSI heart sections (exercise #2) to determine whether that approach increased consistency of diagnosis of rodent progressive cardiomyopathy (PCM) lesions. In exercise #2, there was improved consistency of categorization of small borderline morphologies and mild lesions, but a decrement in consistency of categorizing minimal lesions. Exercises 1 and 2 suggest the described diagnostic approach is representative of that in use by the majority of toxicologic pathologists across companies/agencies and that application by all may improve diagnostic consistency of PCM/like lesions. Additionally, a criterion of approximately 5% heart section involvement is suggested for separating mild from moderate or greater severity. While evidence is not absolute, until further investigation shows otherwise, microscopic changes resembling PCM, but located in the epicardial and subepicardial region of the right ventricle, may be considered as part of the spectrum of PCM.

Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?

Science.gov (United States)

Yang, Pan; Peng, Yulan; Zhao, Haina; Luo, Honghao; Jin, Ya; He, Yushuang

2015-01-01

Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies. To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions. One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated. The maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate. Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.

Imaging granulomatous lesions with optical coherence tomography

DEFF Research Database (Denmark)

Banzhaf, Christina; Jemec, Gregor B E

2012-01-01

To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors.......To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors....

Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients.

Directory of Open Access Journals (Sweden)

Ismael Alves Rodrigues Júnior

Full Text Available BACKGROUND: Leprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST. Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods. METHODOLOGY/PRINCIPAL FINDINGS: This work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain. The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6 and 80.8% (SD = 24.9, respectively. CONCLUSIONS/SIGNIFICANCE: We observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its

Reappraisal of in situ immunophenotypic analysis of psoriasis skin: interaction of activated HLA-DR+ immunocompetent cells and endothelial cells is a major feature of psoriatic lesions

NARCIS (Netherlands)

de Boer, O. J.; van der Loos, C. M.; Hamerlinck, F.; Bos, J. D.; Das, P. K.

1994-01-01

Psoriasis is an inflammatory skin disease of unknown aetiology. Many observations indicate that T cells play an important role in the pathogenesis of the disease. Upregulation of MHC class-II molecules on immunocompetent cells, endothelial cells and keratinocytes on lesional psoriatic skin has been

Intraosseous osteolytic lesions

Energy Technology Data Exchange (ETDEWEB)

Adler, C.P.; Wenz, W.

1981-10-01

Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

CD1a, HAM56, CD68 and S-100 are present in lesional skin biopsies from patients affected by autoimmune blistering diseases

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Ana Maria Abreu Velez

2014-04-01

Full Text Available Introduction: Previous research on autoimmune skin blistering diseases (ABD has primarily focused on the humoral immune response; moreover, little attention has been given to the potential role of the antigen presenting cells (APCs in lesional skin. Aim: The purpose of our study was to immunophenotype selected APC in the lesional skin of ABDs, utilizing immunohistochemistry (IHC stains. Materials and Methods: We utilized IHC to stain for dendritic cells (DC, staining with CD1a, CD68, HAM56, and S-100 in lesional skin from 30 patients with endemic pemphigus foliaceus (EPF, 15 controls from the EPF endemic area, and 15 healthy controls from the USA. We also tested archival biopsies from patients with selected ABD, including 30 patients with bullous pemphigoid (BP, 20 with pemphigus vulgaris (PV, 8 with pemphigus foliaceus (PF and 14 with dermatitis herpetiformis (DH and 2 with epidermolysis bullosa acquisita (EBA. Results: Cells stained by CD68, HAM56 and S-100 were present in the majority of the ABD skin biopsies; these cells were located primarily in perivascular infiltrates surrounding dermal vessels subjacent to the blisters. However, these cells were also noted within the blisters, in vessels supplying dermal eccrine glands and ducts, and in areas of dermal endothelial-mesenchymal cell junction-like structures, especially in BP cases. In our CD1a staining, the number and location of positive staining cells varied with each disease, being abundant in most ABD in the epidermis suprajacent to the blisters, or in the epidermis surrounding the blister site if the blister site epidermis was missing. In the control biopsies, most did not display positive IHC staining, with the exception of a few CD1a positive cells in the epidermis Conclusion: Our findings confirm positive IHC staining for APCs in areas of the skin besides the disease blisters. Our findings suggest that the antigen presentation in ABD proceeds in areas distant from the blister site

Advances in the in Vivo Raman Spectroscopy of Malignant Skin Tumors Using Portable Instrumentation

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Nikolaos Kourkoumelis

2015-06-01

Full Text Available Raman spectroscopy has emerged as a promising tool for real-time clinical diagnosis of malignant skin tumors offering a number of potential advantages: it is non-intrusive, it requires no sample preparation, and it features high chemical specificity with minimal water interference. However, in vivo tissue evaluation and accurate histopathological classification remain a challenging task for the successful transition from laboratory prototypes to clinical devices. In the literature, there are numerous reports on the applications of Raman spectroscopy to biomedical research and cancer diagnostics. Nevertheless, cases where real-time, portable instrumentations have been employed for the in vivo evaluation of skin lesions are scarce, despite their advantages in use as medical devices in the clinical setting. This paper reviews the advances in real-time Raman spectroscopy for the in vivo characterization of common skin lesions. The translational momentum of Raman spectroscopy towards the clinical practice is revealed by (i assembling the technical specifications of portable systems and (ii analyzing the spectral characteristics of in vivo measurements.

Paracoccidioidomicose: freqüência, morfologia e patogênese de lesões tegumentares Paracoccidioidomycosis: frequency, morphology, and pathogenesis of tegumentary lesions

Directory of Open Access Journals (Sweden)

Silvio Alencar Marques

2007-10-01

Full Text Available FUNDAMENTOS: Paracoccidioidomicose é micose sistêmica de alta prevalência no Brasil. As lesões orocutâneas são de importância para o diagnóstico e acompanhamento clínico. OBJETIVO: Quantificar e qualificar a presença de lesões cutâneas em pacientes com paracoccidioidomicose e correlacionar com forma clínica e gravidade dos casos. MÉTODOS: Realizou-se estudo clínico observacional de série de casos, classificados segundo a forma clínica, localização topográfica e morfologia da lesão quando presente. RESULTADOS: Foram estudados 152 pacientes classificados como forma crônica do adulto (87,5% ou como forma aguda-subaguda, tipo juvenil (12,5%. Lesão cutânea foi identificada em 61,2% dos pacientes. Não houve correlação estatística entre presença de lesão e forma clínica (p=1,000 ou entre presença de lesão e gravidade clínica (p= 0,5607. Houve correlação entre presença de lesão mucosa e a forma clínica crônica do adulto (pBACKGROUND: Paracoccidioidomycosis is a highly prevalent systemic mycosis in Brazil. The oral and cutaneous lesions are useful for diagnostic proposals and clinical follow-up. OBJECTIVE: To quantify and qualify skin lesions associated to active paracoccidioidomycosis and to correlate them with the clinical form and severity of cases. METHODS: An observational clinical study of cases was performed. Patients were classified according to the clinical form, topographic distribution and morphology of skin lesions. RESULTS: A total of 152 patients classified as chronic form (adult type (87.5% or acute-subacute form (juvenile type (12.5% were studied. Skin lesion was diagnosed in 61.2% of patients. There was no statistical correlation between presence of skin lesion and clinical form (p=1.000, nor between skin lesion and severity of disease (p=0.5607. There was statistical correlation between mucosal lesion and adult patients (p <0.001. The lesions were on the cephalic segment (47.6%, trunk (14

Added diagnostic value of respiratory-gated 4D 18F-FDG PET/CT in the detection of liver lesions. A multicenter study

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Crivellaro, Cinzia; Landoni, Claudio; Guerra, Luca [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); University of Milan-Bicocca, Milan (Italy); De Ponti, Elena; Morzenti, Sabrina [San Gerardo Hospital, Medical Physics, Monza (Italy); Elisei, Federica [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); Picchio, Maria; Bettinardi, Valentino [IRCCS San Raffaele Scientific Institute, Nuclear Medicine, Milan (Italy); Versari, Annibale [Santa Maria Nuova Hospital IRCCS, Nuclear Medicine, Reggio Emilia (Italy); Fioroni, Federica [Santa Maria Nuova Hospital IRCCS, Medical Physics, Reggio Emilia (Italy); Dziuk, Miroslaw; Tkaczewski, Konrad [Military Institute of Medicine, Warsaw (Poland); Ahond-Vionnet, Renee; Nodari, Guillaume [Hopital Pierre Beregovoy, Service de Medecine Nucleaire, Nevers (France); Todde, Sergio [University of Milan-Bicocca, Tecnomed Foundation, Monza (Italy)

2018-01-15

The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18F-FDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3D-PET/CT and liver 4D-PET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4D-PET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4D-PET/CT. Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3D-PET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4D-PET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4D-PET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4D-PET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4D-PET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3D-PET (mean ± SD, 5.2 ± 2.3). Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic

Autofluorescence of pigmented skin lesions using a pulsed UV laser with synchronized detection: clinical results

DEFF Research Database (Denmark)

Cheng, Haynes Pak Hay; Svenmarker, Pontus; Tidemand-Lichtenberg, Peter

2010-01-01

signal, which may in turn produce high contrast images that improve diagnosis, even in the presence of ambient room light. The synchronized set-up utilizes a compact, diode pumped, pulsed UV laser at 355 nm which is coupled to a CCD camera and a liquid crystal tunable filter. The excitation and image......We report preliminary clinical results of autofluorescence imaging of malignant and benign skin lesions, using pulsed 355 nm laser excitation with synchronized detection. The novel synchronized detection system allows high signal-to-noise ratio to be achieved in the resulting autofluorescence...

Synthetic Peptide Drugs for Targeting Skin Cancer: Malignant Melanoma and Melanotic Lesions.

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Eberle, Alex N; Rout, Bhimsen; Qi, Mei Bigliardi; Bigliardi, Paul L

2017-01-01

Peptides play decisive roles in the skin, ranging from host defense responses to various forms of neuroendocrine regulation of cell and organelle function. Synthetic peptides conjugated to radionuclides or photosensitizers may serve to identify and treat skin tumors and their metastatic forms in other organs of the body. In the introductory part of this review, the role and interplay of the different peptides in the skin are briefly summarized, including their potential application for the management of frequently occurring skin cancers. Special emphasis is given to different targeting options for the treatment of melanoma and melanotic lesions. Radionuclide Targeting: α-Melanocyte-stimulating hormone (α-MSH) is the most prominent peptide for targeting of melanoma tumors via the G protein-coupled melanocortin-1 receptor that is (over-)expressed by melanoma cells and melanocytes. More than 100 different linear and cyclic analogs of α-MSH containing chelators for 111In, 67/68Ga, 64Cu, 90Y, 212Pb, 99mTc, 188Re were synthesized and examined with experimental animals and in a few clinical studies. Linear Ac-Nle-Asp-His-D-Phe-Arg-Trp-Gly-Lys-NH2 (NAP-amide) and Re-cyclized Cys- Cys-Glu-His-D-Phe-Arg-Trp-Cys-Arg-Pro-Val-NH2 (Re[Arg11]CCMSH) containing different chelators at the N- or C-terminus served as lead compounds for peptide drugs with further optimized characteristics. Alternatively, melanoma may be targeted with radiopeptides that bind to melanin granules occurring extracellularly in these tumors. Photosensitizer targeting: A more recent approach is the application of photosensitizers attached to the MSH molecule for targeted photodynamic therapy using LED or coherent laser light that specifically activates the photosensitizer. Experimental studies have demonstrated the feasibility of this approach as a more gentle and convenient alternative compared to radionuclides. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Spectrophotometric intracutaneous analysis versus dermoscopy for the diagnosis of pigmented skin lesions: prospective, double-blind study in a secondary reference centre

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Glud, Martin; Gniadecki, Robert; Drzewiecki, Krzysztof T

2009-01-01

Dermoscopy is considered to be the golden standard for the clinical assessment of pigmented skin lesions. In expert hands, this instrument improves both sensitivity and specificity for the diagnosis of melanoma, however, the outcome is highly dependent on the skills and experience of the examiner...

Diagnostic challenges of tubercular lesions of breast

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Jairajpuri, Zeeba Shamim; Jetley, Sujata; Rana, Safia; Khetrapal, Shaan; Khan, Sabina; Hassan, Mohammad Jaseem

2018-01-01

INTRODUCTION: Tuberculosis (TB) in the developing countries presents with both pulmonary and extrapulmonary manifestations. Breast TB, however, remains a rare presentation. Its importance lies in the fact that it may mimic malignancy or present as inflammatory lump/abscess. AIMS AND OBJECTIVE: The aim of the present study is to highlight the importance of breast TB and its diagnostic challenges. MATERIALS AND METHODS: It was a retrospective study conducted at a tertiary care hospital, over 2 years between 2013 and 2015 during which eight cases of breast lesions were diagnosed as of tubercular origin. RESULTS: Granulomas were seen in five cases while three cases revealed only few epithelioid cells, and necrosis was seen in all cases on fine-needle aspiration cytology. Histopathological evaluation was available in six out of the eight cases, while acid–fast bacilli were positive in three cases, the characteristic granulomas were seen in all the six cases evaluated. CONCLUSION: Significance of TB breast lies in the fact that it may masquerade as breast malignancy or pyogenic abscess. India is a developing country where TB is endemic, a high index of suspicion should be expressed in evaluating breast masses, and TB should be considered in the differential diagnosis. PMID:29692584

Antibodies against human cytomegalovirus late protein UL94 in the pathogenesis of scleroderma-like skin lesions in chronic graft-versus-host disease.

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Pastano, Rocco; Dell'Agnola, Chiara; Bason, Caterina; Gigli, Federica; Rabascio, Cristina; Puccetti, Antonio; Tinazzi, Elisa; Cetto, Gianluigi; Peccatori, Fedro; Martinelli, Giovanni; Lunardi, Claudio

2012-09-01

Human cytomegalovirus (hCMV) infection and its reactivation correlate both with the increased risk and with the worsening of graft-versus-host disease (GVHD). Because scleroderma-like skin lesions can occur in chronic GVHD (cGVHD) in allogeneic stem-cell transplant (HCT) patients and hCMV is relevant in the pathogenesis of systemic sclerosis (SSc), we evaluated the possible pathogenetic link between hCMV and skin cGVHD. Plasma from 18 HCT patients was tested for anti-UL94 and/or anti-NAG-2 antibodies, identified in SSc patients, by direct ELISA assays. Both donors and recipients were anti-hCMV IgG positive, without autoimmune diseases. Patients' purified anti-UL94 and anti-NAG-2 IgG binding to human umbilical endothelial cells (HUVECs) and fibroblasts was performed by FACS analysis and ELISA test. HUVECs apoptosis and fibroblasts proliferation induced by patients' anti-NAG-2 antibodies were measured by DNA fragmentation and cell viability, respectively. About 11/18 patients developed cGVHD and all of them showed skin involvement, ranging from diffuse SSc-like lesions to limited erythema. Eight of eleven cGVHD patients were positive for anti-UL94 and/or anti-NAG-2 antibodies. Remarkably, 4/5 patients who developed diffuse or limited SSc-like lesions had antibodies directed against both UL94 and NAG-2; their anti-NAG-2 IgG-bound HUVECs and fibroblasts induce both endothelial cell apoptosis and fibroblasts proliferation, similar to that induced by purified anti-UL94 and anti-NAG-2 antibodies obtained from SSc patients. In conclusion, our data suggest a pathogenetic link between hCMV infection and scleroderma-like skin cGVHD in HCT patients through a mechanism of molecular mimicry between UL94 viral protein and NAG-2 molecule, as observed in patients with SSc.

Virtual microscopy: an evaluation of its validity and diagnostic performance in routine histologic diagnosis of skin tumors

DEFF Research Database (Denmark)

Nielsen, Patricia Switten; Lindebjerg, Jan; Rasmussen, Jan

2010-01-01

Digitization of histologic slides is associated with many advantages, and its use in routine diagnosis holds great promise. Nevertheless, few articles evaluate virtual microscopy in routine settings. This study is an evaluation of the validity and diagnostic performance of virtual microscopy...... in routine histologic diagnosis of skin tumors. Our aim is to investigate whether conventional microscopy of skin tumors can be replaced by virtual microscopy. Ninety-six skin tumors and skin-tumor-like changes were consecutively gathered over a 1-week period. Specimens were routinely processed, and digital...... slides were captured on Mirax Scan (Carl Zeiss MicroImaging, Göttingen, Germany). Four pathologists evaluated the 96 virtual slides and the associated 96 conventional slides twice with intermediate time intervals of at least 3 weeks. Virtual slides that caused difficulties were reevaluated to identify...

Differentiation of involved and uninvolved psoriatic skin from healthy skin using noninvasive visual, colorimeter and evaporimeter methods.

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Pershing, L K; Bakhtian, S; Wright, E D; Rallis, T M

1995-08-01

Uninvolved skin of psoriasis may not be entirely normal. The object was to characterize healthy, uninvolved psoriatic skin and lesional skin by biophysical methods. Involved and uninvolved psoriatic and age-gender matched healthy skin was measured objectively with a colorimeter and evaporimeter and subjectively with visual assessment in 14 subjects. Visual assessment of erythema (E), scaling (S) and induration (I) as well as the target lesion score at the involved psoriatic skin sites were significantly elevated (puninvolved psoriatic skin >healthy skin (pcolorimeter L* and a* scale values at uninvolved psoriatic skin sites were lower and higher (pcolorimeter description (L*× b*)/a* significantly differentiated healthy skin from both involved and uninvolved psoriatic skin. These collective data highlight that even visually appearing uninvolved psoriatic skin is compromised compared with healthy skin. These objective, noninvasive but differential capabilities of the colorimeter and evaporimeter will aid in the mechanistic quantification of new psoriatic drug therapies and in conjuction with biochemical studies, add to understanding of the multifactorial pathogenesis of psoriasis.

High frequency ultrasonography of the skin and its role as an auxillary tool in diagnosis of benign and malignant cutaneous tumors--a comparison of two clinical cases.

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Dybiec, Ewa; Pietrzak, Aldona; Adamczyk, Michal; Michalska-Jakubus, Malgorzata; Wawrzycki, Bartlomiej; Lotti, Torello; Rutkowski, Piotr; Krasowska, Dorota

2015-01-01

The number of dermatologic entities that can be studied by ultrasound examination (US) of the skin is increasing. Conventional US and high frequency US (HFUS) are considered useful additional tools in improving the diagnosis and management of common benign and malignant skin tumors. US may help in positive and differential diagnosis of primary melanocytic neoplasms and of locoregional spread in melanoma patients. US preoperative evaluation of primary melanoma thickness correlates with histologically estimated melanoma thickness, and can help determine surgical margins and indications for sentinel lymph node biopsy. It is also useful during follow-up after surgical treatment for early detection of recurrence or metastases. In this case report, we present two cases of skin lesions clinically suspicious for malignancy. The first lesion was a round nodule 3 mm in diameter, resembling a blue nevus. In HFUS it was well delimited, hypoechoic, and well vascularized. The second lesion presented as an elevated, well-circumscribed nodule, 5-6 mm in diameter, inhomogeneous in color. HFUS depicted a poorly delimited, irregular, hypoechoic lesion crossing the dermoepidermal junction. At the first exam it was not vascularized, but 6 months later a number of vascular flow signals within the lesion were found. In histopathological examination the lesions were finally diagnosed as, respectively: benign cavernous hemangioma and melanoma. In both presented cases HFUS proved to be useful in a differential diagnosis of suspicious skin lesions. Noninvasive and easy to perform, HFUS is a valuable diagnostic method in dermatology.

Bee Venom Phospholipase A2 Alleviate House Dust Mite-Induced Atopic Dermatitis-Like Skin Lesions by the CD206 Mannose Receptor.

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Shin, Dasom; Choi, Won; Bae, Hyunsu

2018-04-02

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by highly pruritic, erythematous, and eczematous skin plaques. We previously reported that phospholipase A2 (PLA2) derived from bee venom alleviates AD-like skin lesions induced by 2,4-dinitrochlorobenzene (DNCB) and house dust mite extract ( Dermatophagoides farinae extract, DFE) in a murine model. However, the underlying mechanisms of PLA2 action in actopic dermatitis remain unclear. In this study, we showed that PLA2 treatment inhibited epidermal thickness, serum immunoglobulin E (IgE) and cytokine levels, macrophage and mast cell infiltration in the ear of an AD model induced by DFE and DNCB. In contrast, these effects were abrogated in CD206 mannose receptor-deficient mice exposed to DFE and DNCB in the ear. These data suggest that bvPLA2 alleviates atopic skin inflammation via interaction with CD206.

Self-Inflicted Lesions in Dermatology

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Tomas-Aragones, Lucía; Consoli, Silla M; Consoli, Sylvie G

2017-01-01

The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new psychother......The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new...

Assessing burn depth in tattooed burn lesions with LASCA Imaging

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Krezdorn, N.; Limbourg, A.; Paprottka, F.J.; Könneker; Ipaktchi, R.; Vogt, P.M

2016-01-01

Summary Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours. PMID:28149254

Analytical validation of a melanoma diagnostic gene signature using formalin-fixed paraffin-embedded melanocytic lesions.

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Warf, M Bryan; Flake, Darl D; Adams, Doug; Gutin, Alexander; Kolquist, Kathryn A; Wenstrup, Richard J; Roa, Benjamin B

2015-01-01

These studies were to validate the analytical performance of a gene expression signature that differentiates melanoma and nevi, using RNA expression from 14 signature genes and nine normalization genes that generates a melanoma diagnostic score (MDS). Formalin-fixed paraffin-embedded melanocytic lesions were evaluated in these studies. The overall SD of the assay was determined to be 0.69 MDS units. Individual amplicons within the signature had an average amplification efficiency of 92% and a SD less than 0.5 CT. The MDS was reproducible across a 2000-fold dilution range of input RNA. Melanin, an inhibitor of PCR, does not interfere with the signature. These studies indicate this signature is robust and reproducible and is analytically validated on formalin-fixed paraffin-embedded melanocytic lesions.

Skin Lesions in European Hibernating Bats Associated with Geomyces destructans, the Etiologic Agent of White-Nose Syndrome

OpenAIRE

Wibbelt, Gudrun; Puechmaille, S?bastien J.; Ohlendorf, Bernd; M?hldorfer, Kristin; Bosch, Thijs; G?rf?l, Tam?s; Passior, Karsten; Kurth, Andreas; Lacremans, Daniel; Forget, Fr?d?ric

2013-01-01

White-nose syndrome (WNS) has claimed the lives of millions of hibernating insectivorous bats in North America. Its etiologic agent, the psychrophilic fungus Geomyces destructans, causes skin lesions that are the hallmark of the disease. The fungal infection is characterized by a white powdery growth on muzzle, ears and wing membranes. While WNS may threaten some species of North American bats with regional extinction, infection in hibernating bats in Europe seems not to be associated with si...

Changes in Transepidermal Water Loss and Skin Hydration according to Expression of Aquaporin-3 in Psoriasis

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Lee, Young; Je, Young-Jin; Lee, Sang-Sin; Li, Zheng Jun; Choi, Dae-Kyoung; Kwon, Yoo-Bin; Sohn, Kyung-Cheol; Im, Myung; Seo, Young Joon

2012-01-01

Background Aquaporins (AQPs) are a family of water transporting proteins present in many mammalian epithelial and endothelial cell types. Among the AQPs, AQP3 is known to be a water/glycerol transporter expressed in human skin. Objective The relationship between the expression level of AQP3 and transpidermal water loss (TEWL) in the lesional and peri-lesional skin of psoriasis-affected patients, and skin hydration in the lesional and peri-lesional skin of psoriasis patients, was investigated. Methods The expression of AQP3 in psoriasis-affected and healthy control skin was determined using immunohistochemical and immunofluroscence staining. TEWL and skin hydration were measured using a Tewameter® TM210 (Courage & Khazaka, Cologne, Germany) and a Corneometer® CM 820 (Courage & Khazaka), respectively. Results AQP3 was mainly expressed in the plasma membrane of stratum corneum and the stratum spinosum in normal epidermis. Unlike the normal epidermis, AQP3 showed decreased expression in the lesional and peri-lesional epidermis of psoriasis. TEWL was increased, and skin hydration was decreased, in the lesional and peri-lesional skin of psoriasis patients, compared with the healthy control sample. Conclusion Although various factors contribute to reduced skin hydration in the lesional and peri-lesional skin of psoriasis, AQP3 appears to be a key factor in the skin dehydration of psoriasis-affected skin. PMID:22577267

The Histological and Immunohistochemical Features of the Skin Lesions in CANDLE Syndrome

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Torrelo, Antonio; Colmenero, Isabel; Requena, Luis; Paller, Amy S.; Ramot, Yuval; Lee, Chyi-Chia Richard; Vera, Angel; Zlotogorski, Abraham; Goldbach-Mansky, Raphaela; Kutzner, Heinz

2015-01-01

Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome is a newly characterized autoinflammatory disorder, caused by mutations in PSMB8. It is characterized by early-onset fevers, accompanied by a widespread, violaceous and often annular, cutaneous eruption. While the exact pathogenesis of this syndrome is still obscure, it is postulated that the inflammatory disease manifestations stem from excess secretion of interferons. Based on preliminary blood cytokine and gene expression studies, the signature seems to come mostly from type I interferons, which are proposed to lead to the recruitment of immature myeloid cells into the dermis and subcutis. In this study, we systematically analyzed skin biopsies from 6 CANDLE syndrome patients by routine histopathology and immunohistochemistry methods. Skin lesions showed the presence of extensive mixed dermal and subcutaneous inflammatory infiltrate, composed of mononuclear cells, atypical myeloid cells, neutrophils, eosinophils and some mature lymphocytes. Positive LEDER and myeloperoxidase staining supported the presence of myeloid cells. Positive CD68/PMG1 and CD163 staining confirmed the existence of histiocytes and monocytic macrophages in the inflammatory infiltrate. CD123 staining was positive, demonstrating the presence of plasmacytoid dendritic cells. Uncovering the unique histopathologic and immunohistochemical features of CANDLE syndrome provides tools for rapid and specific diagnosis of this disorder as well as further insight into the pathogenesis of this severe, life-threatening condition. PMID:26091509

Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

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Jan S. Kirschke

2016-01-01

Full Text Available Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA of the ankle in the evaluation of (osteochondral lesions in comparison to conventional magnetic resonance imaging (MRI and intraoperative findings. Methods. A total of N=79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen’s kappa calculations. Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05 for CTA and moderate (0.55 ± 0.07 for MRI. In surgical reports, 88–92% and 46–62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases.

Physiological and molecular characterization of atypical lipid-dependent Malassezia yeasts from a dog with skin lesions: adaptation to a new host?

NARCIS (Netherlands)

Cafarchia, C.; Latrofa, M.S.; Figueredo, L.A.; da Silva Machado, M.L.; Ferreiro, L.; Guillot, J.; Boekhout, T.; Otranto, D.

2011-01-01

Three lipid-dependent Malassezia isolates (here named 114A, 114B and 114C) recovered from a dog with skin lesions were phenotypically and genotypically characterized. All presented ovoid cells and buds formed on a narrow base. Most of the results from physiological tests were consistent with those

Skin Cancer Concerns in People of Color: Risk Factors and Prevention

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Gupta, Alpana K; Bharadwaj, Mausumi; Mehrotra, Ravi

2016-01-01

Background: Though people of color (POC) are less likely to become afflicted with skin cancer, they are much more likely to die from it due to delay in detection or presentation. Very often, skin cancer is diagnosed at a more advanced stage in POC, making treatment difficult. The purpose of this research was to improve awareness regarding skin cancers in people of color by providing recommendations to clinicians and the general public for early detection and photo protection preventive measures. Methods: Data on different types of skin cancers were presented to POC. Due to limited research, there are few resources providing insights for evaluating darkly pigmented lesions in POC. Diagnostic features for different types of skin cancers were recorded and various possible risk factors were considered. Results: This study provided directions for the prevention and early detection of skin cancer in POC based on a comprehensive review of available data. Conclusions: The increased morbidity and mortality rate associated with skin cancer in POC is due to lack of awareness, diagnosis at a more advanced stage and socioeconomic barriers hindering access to care. Raising public health concerns for skin cancer prevention strategies for all people, regardless of ethnic background and socioeconomic status, is the key to timely diagnosis and treatment. PMID:28125871

Detection of pathogenic bacteria in skin lesions of patients with chiclero's ulcer: reluctant response to antimonial treatment

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Isaac-Márquez Angélica Patricia

2003-01-01

Full Text Available We investigated the bacterial flora present in skin lesions of patients with chiclero's ulcer from the Yucatan peninsula of Mexico using conventional culture methods (11 patients, and an immunocolorimetric detection of pathogenic Streptococcus pyogenes (15 patients. Prevalence of bacteria isolated by culture methods was 90.9% (10/11. We cultured, from chiclero's ulcers (60%, pathogenic bacterial such as Staphylococcus aureus (20%, S. pyogenes (1.6%, Pseudomonas aeruginosa (1.6%, Morganella morganii (1.6%, and opportunist pathogenic bacteria such as Klebsiella spp. (20.0%, Enterobacter spp. (20%, and Enterococcus spp. (20%. We also cultured coagulase-negative staphylococci in 40% (4/10 of the remaining patients. Micrococcus spp. and coagulase-negative staphylococci constituted the bacterial genuses more frequently isolated in the normal skin of patients with chiclero's ulcer and healthy individuals used as controls. We also undertook another study to find out the presence of S. pyogenes by an immunocolorimetric assay. This study indicated that 60% (9/15 of the ulcerated lesions, but not normal controls, were contaminated with S. pyogenes. Importantly, individuals with purulent secretion and holding concomitant infections with S. pyogenes, S. aureus, P. aeruginosa, M. morganii, and E. durans took longer to heal Leishmania (L. mexicana infections treated with antimonial drugs. Our results suggest the need to eliminate bacterial purulent infections, by antibiotic treatment, before starting antimonial administration to patients with chiclero's ulcer.

Porcine skin visible lesion thresholds for near-infrared lasers including modeling at two pulse durations and spot sizes.

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Cain, C P; Polhamus, G D; Roach, W P; Stolarski, D J; Schuster, K J; Stockton, K L; Rockwell, B A; Chen, Bo; Welch, A J

2006-01-01

With the advent of such systems as the airborne laser and advanced tactical laser, high-energy lasers that use 1315-nm wavelengths in the near-infrared band will soon present a new laser safety challenge to armed forces and civilian populations. Experiments in nonhuman primates using this wavelength have demonstrated a range of ocular injuries, including corneal, lenticular, and retinal lesions as a function of pulse duration. American National Standards Institute (ANSI) laser safety standards have traditionally been based on experimental data, and there is scant data for this wavelength. We are reporting minimum visible lesion (MVL) threshold measurements using a porcine skin model for two different pulse durations and spot sizes for this wavelength. We also compare our measurements to results from our model based on the heat transfer equation and rate process equation, together with actual temperature measurements on the skin surface using a high-speed infrared camera. Our MVL-ED50 thresholds for long pulses (350 micros) at 24-h postexposure are measured to be 99 and 83 J cm(-2) for spot sizes of 0.7 and 1.3 mm diam, respectively. Q-switched laser pulses of 50 ns have a lower threshold of 11 J cm(-2) for a 5-mm-diam top-hat laser pulse.

Impact of lossy compression on diagnostic accuracy of radiographs for periapical lesions

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Eraso, Francisco E.; Analoui, Mostafa; Watson, Andrew B.; Rebeschini, Regina

2002-01-01

OBJECTIVES: The purpose of this study was to evaluate the lossy Joint Photographic Experts Group compression for endodontic pretreatment digital radiographs. STUDY DESIGN: Fifty clinical charge-coupled device-based, digital radiographs depicting periapical areas were selected. Each image was compressed at 2, 4, 8, 16, 32, 48, and 64 compression ratios. One root per image was marked for examination. Images were randomized and viewed by four clinical observers under standardized viewing conditions. Each observer read the image set three times, with at least two weeks between each reading. Three pre-selected sites per image (mesial, distal, apical) were scored on a five-scale score confidence scale. A panel of three examiners scored the uncompressed images, with a consensus score for each site. The consensus score was used as the baseline for assessing the impact of lossy compression on the diagnostic values of images. The mean absolute error between consensus and observer scores was computed for each observer, site, and reading session. RESULTS: Balanced one-way analysis of variance for all observers indicated that for compression ratios 48 and 64, there was significant difference between mean absolute error of uncompressed and compressed images (P <.05). After converting the five-scale score to two-level diagnostic values, the diagnostic accuracy was strongly correlated (R (2) = 0.91) with the compression ratio. CONCLUSION: The results of this study suggest that high compression ratios can have a severe impact on the diagnostic quality of the digital radiographs for detection of periapical lesions.

[The diagnostic value of ultrasonic elastography and ultrasonography comprehensive score in cervical lesions].

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Lu, R; Xiao, Y

2017-07-18

Objective: To evaluate the clinical value of ultrasonic elastography and ultrasonography comprehensive scoring method in the diagnosis of cervical lesions. Methods: A total of 116 patients were selected from the Department of Gynecology of the first hospital affiliated with Central South University from March 2014 to September 2015.All of the lesions were preoperatively examined by Doppler Ultrasound and elastography.The elasticity score was determined by a 5-point scoring method. Calculation of the strain ratio was based on a comparison of the average strain measured in the lesion with the adjacent tissue of the same depth, size, and shape.All these ultrasonic parameters were quantified, added, and arrived at ultrasonography comprehensive scores.To use surgical pathology as the gold standard, the sensitivity, specificity, accuracy of Doppler Ultrasound, elasticity score and strain ratio methods and ultrasonography comprehensive scoring method were comparatively analyzed. Results: (1) The sensitivity, specificity, and accuracy of Doppler Ultrasound in diagnosing cervical lesions were 82.89% (63/76), 85.0% (34/40), and 83.62% (97/116), respectively.(2) The sensitivity, specificity, and accuracy of the elasticity score method were 77.63% (59/76), 82.5% (33/40), and 79.31% (92/116), respectively; the sensitivity, specificity, and accuracy of the strain ratio measure method were 84.21% (64/76), 87.5% (35/40), and 85.34% (99/116), respectively.(3) The sensitivity, specificity, and accuracy of ultrasonography comprehensive scoring method were 90.79% (69/76), 92.5% (37/40), and 91.38% (106/116), respectively. Conclusion: (1) It was obvious that ultrasonic elastography had certain diagnostic value in cervical lesions. Strain ratio measurement can be more objective than elasticity score method.(2) The combined application of ultrasonography comprehensive scoring method, ultrasonic elastography and conventional sonography was more accurate than single parameter.

[A case of skin autograft for skin ulcers in ichthyosis].

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Li, Shiwei; Yang, Xiaodong; Liu, Lijun; Tang, Xueyang

2017-10-28

Ichthyosis refers to a group of skin diseases characterized by abnormal keratinization of the epidermis, resulting in dryness, roughness and scale of the skin. A girl with ichthyosis, who presented with skin ulcers and infection of the right dorsal foot, was admitted to our department. An autologous razor-thin skin grafting procedure was performed to repair the skin ulcers after debridement and vacuum sealing drain. After 8 months of follow-up, both the donor and recipient site healed well and there were no newly formed ulcers or infections. Although the skin quality of ichthyosis is poor, the lesion area can still be used as donor or recipient cite.

Superficial skin ulcers

International Nuclear Information System (INIS)

Samaila, Modupeola O.; Rafindadi, Abdulmumini H.; Oluwole, Olabode P.; Adewuyi, Sunday A.

2007-01-01

Objective was to determine the underlying cause of superficial skin ulcers over a 15-year period. A retrospective histopathological analysis of 670 cases of superficial skin ulcers diagnosed in the Dept. of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria from January 1991 to December 2005. A total of 670 superficial skin ulcers were analyzed. The mail to female gender ratio was 409:261(1.5:1.0) and a peakage frequency of 44.3 %( 297) in the 5th and 6th decades. Spectrum of lesions encountered was categorized into inflammatory, infections, benign and malignant diseases. The malignant lesions were 309 (46.1%), non-specific inflammation 302 (45.1%), granulation tissue 25 (3.7%) and pseudoepitheliomatous hyperplasia 14 (2.1%). A total of 18(2.7%) specific infections were encountered, which included bacterial, fungal and viral infection. Benign lesions were 2(0.3%), comprising of neurofibroma and Bowen's disease. The most common malignant lesion was squamous cell carcinoma 203 (30.3%) with a male to female ratio of 128:75 (1.7:1.0). Of these 161 were well differentiated tumors. The lower limb was the prevalent site distribution of all the ulcers. Superficial ulcers may be harbinger of malignant diseases. Squamous cell carcinoma remains the most common malignant lesion arising from chronic superficial ulcers from our setting. Adequate tissue biopsy and early diagnosis may reduce the attendant morbidity of these ulcers. (author)

Skin changes in internal malignancy

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Rajagopal Ravi

2004-07-01

Full Text Available BACKGROUND: Internal malignancies are accompanied by various skin changes which may be specific infiltrates or non-specific changes. This study is aimed at determining the frequency of such changes in malignant disease treatment center attendees in India. METHODS: A study of 300 confirmed cases of internal malignancy at a malignant disease treatment center was undertaken to evaluate these skin changes. Specific infiltrates were confirmed by histopathology. Statistical methods were employed to calculate significance in non-specific lesions by comparing with 300 controls not suffering from internal malignancy. RESULTS: Skin changes were present in 82 (27.3%. Cutaneous metastases were found in 19 (6.3%; non-contiguous in 5 (1.6%; contiguous in 14 (4.3%. Non-specific skin lesions numbered 74 (11.6% in 52 patients. Statistically significant non-specific skin changes were acquired ichthyosis, herpes zoster and generalized pruritus. CONCLUSION: Metastases usually occurred late in internal malignancy (17, 5.6% except in a case each of histiocytic lymphoma and non-Hodgkin′s lymphoma (2, 0.7% where the lesions preceded malignancy by 3 months and 1 month respectively. Contiguous nodules were a marker of relapse after surgery in 3 (1%.

No evidence for mutations in exons 1, 8 and 18 of the patched gene in sporadic skin lesions of Brazilian patients

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Granja F.

2003-01-01

Full Text Available There is strong evidence that the patched (PTCH gene is a gene for susceptibility to the nevoid basal cell carcinoma syndrome. PTCH has also been shown to mutate in both familial and sporadic basal cell carcinomas. However, mutations of the gene seem to be rare in squamous cell carcinomas. In order to characterize the role of the gene in the broader spectrum of sporadic skin malignant and pre-malignant lesions, we performed a polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP analysis of genomic DNA extracted from 105 adult patients (46 females and 59 males. There were 66 patients with basal cell carcinomas, 30 with squamous cell carcinomas, 2 with malignant melanomas and 7 patients with precancerous lesions. Two tissue samples were collected from each patient, one from the central portion of the tumor and another from normal skin. Using primers that encompass the entire exon 1, exon 8 and exon 18, where most of the mutations have been detected, we were unable to demonstrate any band shift. Three samples suspected to present aberrant migrating bands were excised from the gel and sequenced directly. In addition, we sequenced 12 other cases, including tumors and corresponding normal samples. A wild-type sequence was found in all 15 cases. Although our results do not exclude the presence of clonal alterations of the PTCH gene in skin cancers or mutations in other exons that were not screened, the present data do not support the presence of frequent mutations reported for non-melanoma skin cancer of other populations.

[Skin cell response after jellyfish sting].

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Adamicová, Katarína; Výbohová, Desanka; Fetisovová, Želmíra; Nováková, Elena; Mellová, Yvetta

2016-01-01

Jellyfish burning is not commonly part of the professional finding in the central Europe health care laboratory. Holiday seaside tourism includes different and unusual presentations of diseases for our worklplaces. Sea water-sports and leisure is commonly connected with jellyfish burning and changes in the skin, that are not precisely described. Authors focused their research on detection of morphological and quantitative changes of some inflammatory cells in the skin biopsy of a 59-years-old woman ten days after a jellyfish stinging. Because of a comparison of findings the biopsy was performed in the skin with lesional and nonlesional skin. Both excisions of the skin were tested by imunohistochemical methods to detect CD68, CD163, CD30, CD4, CD3, CD8, CD20 a CD1a, to detect histiocytes, as well as several clones of lymphocytes and Langerhans cells (antigen presenting cells of skin), CD 117, toluidin blue and chloracetase esterase to detect mastocytes and neutrophils. Material was tested by immunofluorescent methods to detect IgA, IgM, IgG, C3, C4, albumin and fibrinogen. Representative view-fields were documented by microscope photocamera Leica DFC 420 C. Registered photos from both samples of the skin were processed by morphometrical analysis by the Vision Assistant software. A student t-test was used for statistical analysis of reached results. Mean values of individual found cells in the sample with lesion and without lesion were as follows: CD117 -2.64/0.37, CD68-6.86/1.63, CD163-3.13/2.23, CD30-1.36/0.02, CD4-3.51/0.32, CD8-8.22/0.50, CD3-10.69/0.66, CD20-0.56/0.66, CD1a-7.97/0.47 respectively. Generally mild elevation of eosinofils in lesional skin was detected. Increased values of tested cells seen in excision from lesional skin when compared with nonlesional ones were statistically significant in eight case at the level p = 0.033 to 0.001. A not statistically significant difference was found only in the group of CD163+ histiocytes. Authors detected numbers

Pseudolaric acid B extracted from the Chinese medicinal herb Cortex Pseudolaricis ameliorates DNFB-induced atopic dermatitis-like skin lesions in BALB/c mice

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Yi-Teng Wang

2017-10-01

Full Text Available Objective: Pseudolaric acid B (PB is a newly identified diterpenoid isolated from Tujinpi (Cortex Pseudolaricis. In the present study, we aimed to explore the anti-inflammatory effects of PB on atopic dermatitis (AD, as well as the molecular mechanisms underlying its effects. Methods: BALB/c mice treated with 2,4-dinitrofluorobenzene were orally administered with PB (10 mg∙kg-1∙d-1. After evaluating the AD score, serum levels of IgE and the mRNA expression of NLRP3 inflammasome and IL-1β were measured by ELISA and qRT-PCR respectively. Results: The results showed that PB treatment significantly ameliorated the development of AD-like clinical symptoms and effectively suppressed the infiltration of inflammatory cells. Furthermore, PB inhibited the expression of NLRP3 inflammasome and IL-1β in skin lesions, and downregulated serum IgE levels. Conclusion: The anti-inflammatory properties of PB were demonstrated using the 2,4-dinitrofluorobenzene-induced mouse model of AD-like skin lesions. Our study highlighted the potential use of PB as a novel therapeutic agent for the treatment of inflammation-associated skin diseases.

Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy.

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Al-Zuhairy, Ali; Schrøder, Henrik Daa; Plesner, Torben; Abildgaard, Niels; Sindrup, Søren H

2015-02-15

For several decades an association between MGUS, IgM-MGUS in particular, and peripheral neuropathy has been suspected. Several histopathology studies have shown binding of IgM to myelin and a secondary widening of myelin lamellae in cutaneous nerves and in the sural nerve of patients with IgM-MGUS, or Waldenström's Macroglobulinaemia (WM), and peripheral neuropathy. In this retrospective study we investigated the value of skin biopsy examination in the diagnosis of MGUS- and WM-associated peripheral neuropathy. A total of 117 patients, who were examined for an M-component in serum with associated nerve symptoms, had a skin biopsy taken and examined for immunoglobulin deposition in cutaneous nerves. Thirty-five patients were diagnosed with MGUS or WM and peripheral neuropathy with no other cause of neuropathy. Nineteen patients had MGUS but no peripheral neuropathy. Of the 35 patients with MGUS or WM and peripheral neuropathy, four had immunoglobulin deposition in the skin biopsy, all of whom had an IgM gammopathy. In the control group of 19 without peripheral neuropathy, three had immunoglobulin deposition in the skin biopsy, all of whom had IgM-MGUS. In both groups, there was a trend towards higher IgM blood levels in patients with immunoglobulin deposition. Half of the patients with IgM gammopathy in the neuropathy group had anti-MAG reactivity, whereas only one in the control group had weak anti-MAG reactivity. Our study indicates that examination of skin biopsies for immunoglobulin deposition does not add significant diagnostic value in the evaluation of neuropathies suspected to be caused by MGUS or WM. IgM immunoglobulin deposition in skin biopsy might merely be an epiphenomenon secondary to high IgM blood levels. Copyright © 2014 Elsevier B.V. All rights reserved.

Ulcerative Cutaneous Lesions Synchronously Present with the Diagnosis of Primary Lung Cancer

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Khaldoon Shaheen

2013-01-01

Full Text Available The percentage of patients with lung cancer that develop skin metastases is low. The diagnosis is usually made using clinical information and skin biopsy in patients with suspicious skin lesions and history of smoking or lung cancer. The prognosis for patients having lung cancer with skin metastasis is very poor. We describe findings in a 70-year-old man with lung cancer with skin metastases. Interestingly, multiple skin lesions were the first manifestation of the underlying lung cancer. The prognosis for patients having lung cancer with skin metastasis is thus very poor.

THE FREQUENT SKIN DISEASES DIAGNOSED AT UNIVERSITY STUDENTS

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Yesim KAYMAK

2005-12-01

Full Text Available The incidence of some skin diseases are increasing at adolescent and early adulthood period. The most frequent disease at this period is acne vulgaris whereas fungal diseases, dermatitis, dermatosis which are due to stress and other reasons, oral mucosal lesions and herpetic lesions of perioral region are also frequent. In this research we aim to determine the frequent dermatologic diseases of university students and 147 female, 74 male, a total of 221 students are included. We questioned the dermatologic complaints of students, then examined dermatologically in detail and registered ages, sexes, findings of the dermatological examination and dermatological diagnostic informations. As a result it is found out that the most frequent diseases are acne vulgaris (34.1%, allergic and pruritic dermatosis (16.6%, fungal diseases ( 13.0%, and eritamatous-squamous disease (8.3%. [TAF Prev Med Bull 2005; 4(6.000: 313-320

Th17 Cells and Activated Dendritic Cells Are Increased in Vitiligo Lesions

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Fuentes-Duculan, Judilyn; Moussai, Dariush; Gulati, Nicholas; Sullivan-Whalen, Mary; Gilleaudeau, Patricia; Cohen, Jules A.; Krueger, James G.

2011-01-01

Background Vitiligo is a common skin disorder, characterized by progressive skin de-pigmentation due to the loss of cutaneous melanocytes. The exact cause of melanocyte loss remains unclear, but a large number of observations have pointed to the important role of cellular immunity in vitiligo pathogenesis. Methodology/Principal Findings In this study, we characterized T cell and inflammation-related dermal dendritic cell (DC) subsets in pigmented non-lesional, leading edge and depigmented lesional vitiligo skin. By immunohistochemistry staining, we observed enhanced populations of CD11c+ myeloid dermal DCs and CD207+ Langerhans cells in leading edge vitiligo biopsies. DC-LAMP+ and CD1c+ sub-populations of dermal DCs expanded significantly in leading edge and lesional vitiligo skin. We also detected elevated tissue mRNA levels of IL-17A in leading edge skin biopsies of vitiligo patients, as well as IL-17A positive T cells by immunohistochemistry and immunofluorescence. Langerhans cells with activated inflammasomes were also noted in lesional vitiligo skin, along with increased IL-1ß mRNA, which suggest the potential of Langerhans cells to drive Th17 activation in vitiligo. Conclusions/Significance These studies provided direct tissue evidence that implicates active Th17 cells in vitiligo skin lesions. We characterized new cellular immune elements, in the active margins of vitiligo lesions (e.g. populations of epidermal and dermal dendritic cells subsets), which could potentially drive the inflammatory responses. PMID:21541348

Pathology of post-kala-azar dermal leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes

DEFF Research Database (Denmark)

Ismail, Ahmed; Gadir, A Fattah A; Theander, Thor G

2006-01-01

BACKGROUND: Whereas the clinical manifestations and treatment of post-kala-azar dermal leishmaniasis (PKDL) have been adequately described before, the pathology received little attention, particularly the African form of PKDL which shows some clinical differences from the disease in India...... leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes....

Bee Venom Phospholipase A2 Ameliorates House Dust Mite Extract Induced Atopic Dermatitis Like Skin Lesions in Mice.

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Jung, Kyung-Hwa; Baek, Hyunjung; Kang, Manho; Kim, Namsik; Lee, Seung Young; Bae, Hyunsu

2017-02-18

Atopic dermatitis (AD) is a biphasic inflammatory skin disease that is provoked by epidermal barrier defects, immune dysregulation, and increased skin infections. Previously, we have demonstrated that bvPLA2 evoked immune tolerance by inducing regulatory T cells (Treg), and thus alleviated Th2 dominant allergic asthma in mice. Here, we would like to determine whether treatment with bvPLA2 exacerbates the AD-like allergic inflammations induced by house dust mite extract (DFE) in a murine model. Epidermal thickness, immune cell infiltration, serum immunoglobulin, and cytokines were measured. Ear swelling, skin lesions, and the levels of total serum IgE and Th1/Th2 cytokines were elevated in DFE/DNCB-induced AD mice. Topical application of bvPLA2 elicited significant suppression of the increased AD symptoms, including ear thickness, serum IgE concentration, inflammatory cytokines, and histological changes. Furthermore, bvPLA2 treatment inhibited mast cell infiltration into the ear. On the other hand, Treg cell depletion abolished the anti-atopic effects of bvPLA2, suggesting that the effects of bvPLA2 depend on the existence of Tregs. Taken together, the results revealed that topical exposure to bvPLA2 aggravated atopic skin inflammation, suggesting that bvPLA2 might be a candidate for the treatment of AD.

Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

International Nuclear Information System (INIS)

Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin; Kogler, Michael; Schmaranzer, Ehrenfried; Forstner, Thomas; Reichkendler, Markus

2015-01-01

To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

Energy Technology Data Exchange (ETDEWEB)

Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin [Medical University Innsbruck, Department of Radiology, Innsbruck (Austria); Kogler, Michael; Schmaranzer, Ehrenfried [District Hospital St. Johann in Tyrol, Department of Radiology, St. Johann in Tyrol (Austria); Forstner, Thomas [Johannes Keppler University, Department for Applied Systems Research and Statistics, Linz (Austria); Reichkendler, Markus [District Hospital St. Johann in Tyrol, Department of Orthopedic Surgery, St. Johann in Tyrol (Austria)

2015-06-01

To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

Comparison of diagnostic accuracy of {sup 111}In-pentetreotide SPECT and {sup 68}Ga-DOTATOC PET/CT: A lesion-by-lesion analysis in patients with metastatic neuroendocrine tumours

Energy Technology Data Exchange (ETDEWEB)

Binnebeek, S. van; Vanbilloen, B.; Baete, K.; Terwinghe, C.; Koole, M.; Mortelmans, L. [KU Leuven, Nuclear Medicine, University Hospitals Leuven and Department of Imaging and Pathology, Leuven (Belgium); Mottaghy, F.M. [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Clement, P.M. [KU Leuven, Medical Oncology, University Hospitals Leuven and Laboratory of Experimental Oncology, Leuven (Belgium); Bogaerts, K. [KU Leuven and UHasselt, Department of Public Health and Primary Care (I-BioStat), Leuven (Belgium); Haustermans, K. [KU Leuven, Radiation Oncology, University Hospitals Leuven and Department of Oncology, Leuven (Belgium); Nackaerts, K. [University Hospitals Leuven, Pulmonology, Leuven (Belgium); Cutsem, E. van; Verslype, C. [KU Leuven, Division of Digestive Oncology, University Hospitals Leuven and Department of Oncology, Leuven (Belgium); Verbruggen, A. [KU Leuven, Laboratory for Radiopharmacy, Leuven (Belgium); Deroose, C.M. [KU Leuven, Nuclear Medicine, University Hospitals Leuven and Department of Imaging and Pathology, Leuven (Belgium); University Hospitals Leuven, Nuclear Medicine, Leuven (Belgium)

2016-03-15

To compare the diagnostic accuracy of {sup 111}In-pentetreotide-scintigraphy with {sup 68}Ga-DOTATOC-positron emission tomography (PET)/computed tomography (CT) in patients with metastatic-neuroendocrine tumour (NET) scheduled for peptide receptor radionuclide therapy (PRRT). Incremental lesions (ILs) were defined as lesions observed on only one modality. Fifty-three metastatic-NET-patients underwent {sup 111}In-pentetreotide-scintigraphy (24 h post-injection; planar+single-photon emission CT (SPECT) abdomen) and whole-body {sup 68}Ga-DOTATOC-PET/CT. SPECT and PET were compared in a lesion-by-lesion and organ-by-organ analysis, determining the total lesions and ILs for both modalities. Significantly more lesions were detected on {sup 68}Ga-DOTATOC-PET/CT versus {sup 111}In-pentetreotide-scintigraphy. More specifically, we observed 1,098 lesions on PET/CT (range: 1-105; median: 15) versus 660 on SPECT (range: 0-73, median: 9) (p<0.0001), with 439 PET-ILs (42/53 patients) and one SPECT-IL (1/53 patients). The sensitivity for PET/CT was 99.9 % (95 % CI, 99.3-100.0), for SPECT 60.0 % (95 % CI, 48.5-70.2). The organ-by-organ analysis showed that the PET-ILs were most frequently visualized in liver and skeleton. Ga-DOTATOC-PET/CT is superior for the detection of NET-metastases compared to {sup 111}In-pentetreotide SPECT. (orig.)

Oral administration of Uncariae rhynchophylla inhibits the development of DNFB-induced atopic dermatitis-like skin lesions via IFN-gamma down-regulation in NC/Nga mice.

Science.gov (United States)

Kim, Dong-Young; Jung, Jung-A; Kim, Tae-Ho; Seo, Sang-Wan; Jung, Sung-Ki; Park, Cheung-Seog

2009-04-21

Uncariae rhynchophylla (UR) is an herb which has blood pressure lowering and anti-inflammatory effects and has been prescribed traditionally to treat stroke and vascular dementia. In the present study, we examined whether UR suppress Atopic dermatitis (AD)-like skin lesions in NC/Nga mice treated with 2, 4-dinitrofluorobenzene (DNFB) under SPF conditions. The effect of UR in DNFB- treated NC/Nga mice was determined by measuring the skin symptom severity, levels of serum IgE, and of the amounts of IL-4 and IFN-gamma secreted by activated T cells in draining lymph nodes. Oral administration of UR to DNFB-treated NC/Nga mice was found to inhibit ear thickness increases and the skin lesions induced by DNFB. IFN-gamma production by CD4+ T cells from the lymph nodes of DNFB-treated NC/Nga mice was significantly inhibited by UR treatment, although levels of IL-4 and total IgE in serum were not. UR may suppress the development of AD-like dermatitis in DNFB-treated NC/Nga mice by reducing IFN-gamma production.

Skin lesions over the pocket area that may mimic cardiac implantable electronic device infection: A case series.

Science.gov (United States)

Korantzopoulos, Panagiotis; Plakoutsi, Sofia; Florou, Elizabeth; Bechlioulis, Aris

2018-05-21

The early and correct diagnosis of cardiac implantable electronic device (CIED) infections is critical given that early aggressive treatment with complete removal of the system along with antimicrobial therapy dramatically improves outcomes. Pocket infection manifested by local signs of inflammation is the most common form of CIED infections. Conditions mimicking pocket infection have been described in the literature. These include various types of malignancy and rarely allergic reactions/contact dermatitis to pacemaker compounds. We aimed to describe skin lesions and disorders over the pocket area that mimic CIED infection. We present a series of 5 cases with skin lesions that mimic pocket infection. We document these cases with corresponding photographs. Most of them have not been described in this setting. We report the following cases of conditions that proved not to be CIED infection: One case of superficial cellulitis, one case of herpes zoster over the pocket area, one case of spontaneous bruising over the pocket a long time after implantation in a patient taking oral anticoagulation, and 2 cases of contact dermatitis due to prolonged postoperative application of povidone iodine. All cases had favorable outcome after conservative treatment and no CIED infection was developed during follow-up. Clinicians should be aware of rare conditions that mimic CIED infection. Incorrect diagnosis of these disorders may falsely lead to CIED extraction. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions

International Nuclear Information System (INIS)

Cakir, Ozgur; Arslan, Arzu; Inan, Nagihan; Anık, Yonca; Sarısoy, Tahsin; Gumustas, Sevtap; Akansel, Gur

2013-01-01

Purpose: To evaluate the diagnostic efficiency of the diffusion parameters measured by conventional diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for discrimination of malignant breast lesions from benign lesions and the normal breast. Materials and methods: The study included 52 women with 55 breast lesions (30 malignant, 25 benign). DTI and DWI were performed complementary to dynamic contrast MRI at 3T. Apparent diffusion coefficient (ADC) of DWI, mean diffusivity (MD) and fractional anisotropy (FA) values of DTI were measured for lesions and contralateral breast parenchyma in each patient. We used b factors of 0, 50, 850, 1000 and 1500 s/mm 2 for DWI and b 0 and 1000 s/mm 2 for DTI. ADC, MD and FA values were compared between malignant and benign lesions, and the normal parenchyma by univariate and multivariate analyses. Results: Diffusion parameters showed no difference according to menopausal status in the normal breast. ADC and MD values of the malignant lesions were significantly lower than benign lesions and normal parenchyma (p = 0.001). The FA showed no statistical significance. With the cut-off values of ≤1.23 × 10 −3 mm 2 /s (b 0–1000 s/mm 2 ) and ≤1.12 × 10 −3 mm 2 /s (b 0–1500 s/mm 2 ), ADC showed 92.85% and 96.15% sensitivity; 72.22% and 73.52% PPV, respectively. With a cut-off value of ≤1.27 × 10 −3 mm 2 /s (b 1000 s/mm 2 ), MD was 100% sensitive with a PPV of 65.90%. Comparing the diagnostic performance of the parameters in DTI with DWI, we obtained similar efficiency of ADC with b values of 0,1000 and 0,1500 s/mm 2 and MD with a b value of 0, 1000 s/mm 2 (AUC = 0.82 ± 0.07). Conclusion: ADC of DWI and MD of DTI values provide significant discriminative factors for benign and malignant breast lesions. FA measurement was not discriminative. Supported with clinical and dynamic contrast MRI findings, DWI and DTI findings provide significant contribution to the final radiologic decision

Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions