| 1. |
- Osmancevic, Amra, 1968, et al.
(författare)
-
Size of the exposed body surface area, skin erythema and body mass index predict skin production of vitamin D
- 2015
-
Ingår i: Journal of Photochemistry and Photobiology B-Biology. - : Elsevier BV. - 1011-1344. ; 149, s. 224-229
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Cholecalciferol (vitamin D-3), produced in the skin by UVB irradiation (290-315 nm) of 7-dehydrocholesterol, is metabolized in the liver into 25-hydroxyvitamin D [25(OH)D] which is a major circulating metabolite. Aim: To examine changes in serum concentrations of cholecalciferol and its metabolites after UVB exposure of different skin areas. Methods: 21 healthy Caucasians (skin type II and III, aged 23-47 years) were exposed to broadband UVB (290-320 nm) and randomized to either exposure to one minimal erythema dose given as a single dose, or a suberythemic dose given for 3 subsequent days. The following areas were exposed: face and back of hands, upper half of the body and the whole body, respectively. Serum cholecalciferol and 25(OH)D were measured immediately before start and 24 h after the 1st and last exposure, respectively. Results: Subjects with whole body exposure had an average S-cholecalciferol increase per dose unit of 0.18 ng m1(-1) mJ(-1) cm(2), 0.95 CI: (0.16, 0.20), upper body treatment 0.13 ng ml(-1) mJ(-1) cm(2), 0.95 CI: (0.10, 0.15) and face and hands exposure 0.013 ng ml(-1) mJ(-1) cm(2), 0.95 CI: (-0.012, 0.037). The increase in cholecalciferol correlated positively to the UVB dose and skin erythema and negatively to body mass index (BMI) when controlling for other factors. Exposure of face and hands induces smaller cholecalciferol production in comparison with exposure of larger skin areas. Conclusion: Size of the exposed skin area, UVB dose, skin erythema and BMI were the major determinants for serum levels of skin synthesized cholecalciferol. Exposure of hands and face induces smaller cholecalciferol production in comparison with exposure of larger skin areas.
|
|
| 2. |
- Osmancevic, Amra, 1968, et al.
(författare)
-
Risk factors for osteoporosis and bone status in postmenopausal women with psoriasis treated with UVB therapy.
- 2008
-
Ingår i: Acta dermato-venereologica. - 0001-5555. ; 88:3, s. 240-6
-
Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to examine whether postmenopausal women with psoriasis who were exposed to regular ultraviolet light B (UVB) therapy had greater bone mineral density than women of similar age from the same region, and to estimate the influence of risk factors on bone status. A total of 35 randomly selected women, age (mean +/- SD) 69.3 +/- 6.29 years (age range 60-82 years), with active psoriasis, mean onset at 37.0 years (+/- 23.5 SD) were studied. The patients had been previously exposed to broadband or narrowband UVB. Age-matched, women (n = 2448) from Göteborg, examined at the Geriatric out-patient clinic during the years 2001 and 2002, were used as controls. Bone mineral density was examined by Dual-Energy X-ray Absorptiometry (Hologic Delphi A) at the hip and the lumbar spine. Medical history and lifestyle factors were assessed with a questionnaire. Postmenopausal women with psoriasis were found to have higher bone mineral density than age-matched controls. Higher body weight, physical activity and UVB exposure could explain this finding.
|
|
| 3. |
- Osmancevic, Amra, 1968, et al.
(författare)
-
UVB therapy increases 25(OH) vitamin D syntheses in postmenopausal women with psoriasis.
- 2007
-
Ingår i: Photodermatology, photoimmunology & photomedicine. - : Wiley. - 0905-4383 .- 1600-0781. ; 23:5, s. 172-8
-
Tidskriftsartikel (refereegranskat)abstract
- Keywords: bone mineral density;psoriasis;secondary hyperparathyroidism;UVB therapy;vitamin D Background: Vitamin D3 is produced in the epidermis by ultraviolet (UV) radiation (290–315 nm) of 7-dehydrocholesterol. A similar range of 290–320 nm (broadband UVB) has been successfully used for years to treat psoriasis. The aim of this study was to investigate whether UVB therapy was able to influence vitamin D synthesis in psoriasis patients. Methods: Twenty-four postmenopausal, white Caucasian women, aged 69±5.9 (mean±SD), with active plaque psoriasis, were treated with broadband UVB two to three times per week for 8–12 weeks. The serum concentrations of calcidiol (25(OH)D3), calcitriol (1,25(OH)2D3), intact parathyroid hormone (PTH), thyroid hormones, osteocalcin, calcium and creatinine were measured before the first and after the last dose of radiation. Bone density was measured using Dual-Energy X-ray Absorptiometry (Hologic Delphi A) at the hip and lumbar spine. Results: Serum levels of 25(OH)D3 increased from 36.8±17 ng/ml (mean±SD) to 59.6±18.7 ng/ml (P<0.001) after the UVB treatment period. Serum PTH decreased from 62.8±25.7 ng/l to 48.2±17.4 ng/l (P<0.001). Secondary hyperparathyroidism (PTH>65 ng/l) was revealed in seven patients (29%) in whom PTH values were suppressed by the UVB therapy. The serum levels of calcitriol, calcium, osteocalcin, thyroid hormones and creatinine were unaltered. Conclusion: UVB therapy in elderly psoriatic women improved psoriasis, increased serum 25(OH)D3 synthesis and reduced serum PTH concentrations.
|
|
| 4. |
- Osmancevic, Amra, 1968, et al.
(författare)
-
Vitamin D production after UVB exposure - A comparison of exposed skin regions.
- 2015
-
Ingår i: Journal of photochemistry and photobiology. B, Biology. - : Elsevier BV. - 1873-2682 .- 1011-1344. ; 143, s. 38-43
-
Tidskriftsartikel (refereegranskat)abstract
- Cholecalciferol is an essential steroid produced in the skin by solar ultraviolet B radiation (UVB 290-315nm). Skin production of cholecalciferol depends on factors affecting UVB flux, age and exposed skin area.
|
|
| 5. |
- Osmancevic, Amra, 1968, et al.
(författare)
-
Vitamin D production in psoriasis patients increases less with narrowband than with broadband ultraviolet B phototherapy.
- 2009
-
Ingår i: Photodermatology, photoimmunology & photomedicine. - : Wiley. - 1600-0781 .- 0905-4383. ; 25:3, s. 119-23
-
Tidskriftsartikel (refereegranskat)abstract
- Phototherapy of psoriasis is an effective treatment. In addition to standard broadband ultraviolet radiation B (UVB), (280-320 nm), narrowband phototherapy (NBUVB) (monochromatic UV between 311 and 312 nm) has become an important treatment for psoriasis. The same wavelength range of UVB (290-315 nm) induces synthesis of vitamin D. The aim was to compare the effect of broadband with NBUVB therapy on vitamin D synthesis in patients with psoriasis.
|
|
| 6. |
- Sandberg, Carin, 1969, et al.
(författare)
-
Bioavailability of aminolaevulinic acid and methylaminolaevulinate in basal cell carcinomas: a perfusion study using microdialysis in vivo
- 2008
-
Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 159:5, s. 1170-1176
-
Tidskriftsartikel (refereegranskat)abstract
- Background Photodynamic therapy is becoming a popular treatment for superficial nonmelanoma precancerous and cancerous lesions, showing excellent cosmetic results. Nevertheless, the reported cure rates vary and the transdermal penetration of drugs has been discussed as a limiting factor, particularly for treatment of nodular basal cell carcinoma (BCC). Objectives To investigate the transdermal penetration of aminolaevulinic acid (ALA) and methylaminolaevulinate (MAL) in BCC in vivo using a microdialysis technique. The different prodrugs were compared and the effect of curettage was studied. Methods Twenty patients with 27 histologically verified BCCs (13 superficial, 14 nodular) were included. All lesions were located at the front of the body (head and face excluded). The first 10 patients included were treated with MAL (13 BCCs), and the following 10 patients with ALA (14 BCCs). A light curettage was performed on every second lesion (curettage, n = 13; noncurettage, n = 14). Microdialysis catheters were inserted into the tumours at tissue depths varying from 0.4 to 1.9 mm. Dialysates were collected at 15-30-min intervals for 4 h and the interstitial concentrations of MAL and ALA were determined using high-performance liquid chromatography. Results No significant difference in interstitial drug concentration was observed between lesions treated with ALA or MAL during the 4-h measurement period. However, for the lesions with deeper catheter locations, i.e. at or below 1 mm (n = 11), drug concentrations above the detection limit were obtained in only six lesions. All but one BCC with superficial catheter location, i.e. < 1 mm (n = 16), exhibited detectable drug concentration (P = 0.026). The interstitial peak concentrations were reached within 90 min in 23 of the 27 BCCs, but were not found to be correlated with the depth of the catheters. No difference was found when comparing superficial and nodular BCCs, and the effect of curettage was found to be negligible. Conclusions The results imply that there is no significant difference in transdermal penetration of ALA and MAL in tumour tissue. Detectable levels of drug were not obtained in almost 50% of the lesions where catheters were situated 1-1.9 mm in the lesion. Curettage was not found to affect the interstitial concentration, indicating that penetration of drug indeed might be a problem when treating BCCs thicker than 1 mm.
|
|
| 7. |
- Ceder, Hannah, et al.
(författare)
-
Evaluation of electrical impedance spectroscopy as an adjunct to dermoscopy in short-term monitoring of atypical melanocytic lesions.
- 2016
-
Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 6:4, s. 1-6
-
Tidskriftsartikel (refereegranskat)abstract
- Early detection of melanoma is vital for treatment outcome and survival. Short-term sequential digital dermoscopic monitoring (ST-SDDM) involves the capture and assessment of dermoscopic images of one or more atypical melanocytic lesions (AMLs), at baseline and after four months, in order to detect early morphologic changes. Electrical impedance spectroscopy (EIS) is a diagnostic tool with high sensitivity for the detection of malignant melanocytic lesions.The aim of this study was to assess whether EIS, in addition to ST-SDDM, could improve the selection of AMLs requiring surgery.In this retrospective descriptive study, 22 AMLs in 19 patients were monitored with both ST-SDDM and EIS. A modified EIS decision-making algorithm was established. AMLs were excised if any dermoscopic changes were seen and/or if the EIS score had increased significantly at follow-up. Statistical analyses were made including sensitivity, specificity, PPV and NPV.A total of seven lesions (32%) were excised. Four lesions (57%) were excised solely because of dermoscopic changes including a 0.4 mm-thick melanoma and three benign nevi. Three benign lesions (43%) were excised because of increased EIS scores without any dermoscopic changes. The EIS scores at follow-up showed high variability as compared to the initial scores.The addition of EIS to ST-SDDM did not identify additional malignant lesions. There was no correlation between dermoscopic changes seen with ST-SDDM and increased EIS scores. Three histopathologically benign lesions were needlessly excised. Moreover, the low reproducibility and the possible interoperator variability of the method raised concerns.
|
|
| 8. |
- Dahlén Gyllencreutz, Johan, et al.
(författare)
-
Diagnostic agreement and interobserver concordance with teledermoscopy referrals
- 2017
-
Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 31:5, s. 898-903
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundMalignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient. ObjectiveTo evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images. MethodsThe referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable diagnosis, the priority, and a management decision. ResultsTeledermoscopy generally resulted in higher diagnostic agreement, better triaging and more malignant tumours being booked directly to surgery. The largest difference between the referral methods was seen for invasive melanomas. Referrals for benign lesions were significantly more often correctly resent to primary health care with teledermoscopy. However, referrals for cases of melanoma in situ were also incorrectly resent five times. The interobserver concordance was moderate with both methods. ConclusionBy adding clinical and dermoscopic images to referrals, the triage process for both benign and dangerous skin tumours can be improved. With teledermoscopy, patients with melanoma especially can receive treatment more swiftly.
|
|
| 9. |
- Ericson, Marica B, 1974, et al.
(författare)
-
A spectroscopic study of the photobleaching of protoporphyrin IX in solution
- 2003
-
Ingår i: Lasers in Medical Science. - 0268-8921. ; 18:1, s. 56-62
-
Tidskriftsartikel (refereegranskat)abstract
- Photodynamic therapy (PDT) has developed into an important new clinical treatment for cancer during the past 30 years. The method is non-invasive and based on the photochemical activity of a photosensitising agent present in cells and tissues. In so-called ALA-PDT, protoporphyrin IX (Pp IX) is induced from aminolaevulinic acid (ALA) applied topically or systemically. It has been shown that Pp IX is photodegraded by a photo-oxidation process and that its photoproducts have a characteristic absorption band around 670 nm, as observed both in solution and in cells incubated with ALA. In this study, the involvement of oxygen in the photobleaching process was verified by studying the effect of oxygen depletion using the freeze-pump-thaw (FPT) method. A solution of Pp IX in dimethylformamide (DMF) was exposed to light in the wavelength region 600-700 nm (peak centred at 620 (+/-25) nm) both in the presence and in the absence of oxygen. The bleaching process was observed by absorbance and fluorescence measurements. Photobleaching was observed in the presence of oxygen, as verified by the build-up of a photoproduct absorbing at 670 nm. When the sample was deoxygenated with the FPT method, the photoproduct absorption peak at 670 nm was missing. These results confirm that the formation of photo-protopor-phyrin is a photo-oxidation process and that no photobleaching takes place in the absence of oxygen. When comparing our results to the studies carried out by N-2 bubbling, the N-2 bubbling seems to be insufficient to remove the oxygen completely from the solution.
|
|
| 10. |
- Ericson, Marica B, 1974, et al.
(författare)
-
Bispectral fluorescence imaging combined with texture analysis and linear discrimination for correlation with histopathologic extent of basal cell carcinoma
- 2005
-
Ingår i: Journal of Biomedical Optics. - : SPIE-Intl Soc Optical Eng. - 1083-3668 .- 1560-2281. ; 10:3
-
Tidskriftsartikel (refereegranskat)abstract
- Fluorescence imaging has been shown to be a potential complement to visual inspection for demarcation of basal cell carcinoma (BCC), which is the most common type of skin cancer. Earlier studies have shown promising results when combining autofluorescence with protoporphyrin IX (Pp IX) fluorescence, induced by application of delta-5-aminolaevulinic acid (ALA). In this work, we have tried to further improve the ability of this technique to discriminate between areas of tumor and normal skin by implementing texture analysis and Fisher linear discrimination (FLD) on bispectral fluorescence data of BCCs located on the face. Classification maps of the lesions have been obtained from histopathologic mapping of the excised tumors. The contrast feature obtained from co-occurrence matrices was found to provide useful information, particularly for the ALA-induced Pp IX fluorescence data. Moreover, the neighborhood average features of both autofluorescence and Pp IX fluorescence were preferentially included in the analysis. The algorithm was trained by using a training set of images with good agreement with histopathology, which improved the discriminability of the validation set. In addition, cross validation of the training set showed good discriminability. Our results imply that FLD and texture analysis are preferential for correlation between bispectral fluorescence images and the histopathologic extension of the tumors.
|
|
