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| 2. |
- Börve, Alexander, et al.
(författare)
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Smartphone Teledermoscopy Referrals: A Novel Process for Improved Triage of Skin Cancer Patients.
- 2015
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 95:2, s. 186-190
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Tidskriftsartikel (refereegranskat)abstract
- In this open, controlled, multicentre and prospective observational study, smartphone teledermoscopy referrals were sent from 20 primary healthcare centres to 2 dermatology departments for triage of skin lesions of concern using a smartphone application and a compatible digital dermoscope. The outcome for 816 patients referred via smartphone teledermoscopy was compared with 746 patients referred via the traditional paper-based system. When surgical treatment was required, the waiting time was significantly shorter using teledermoscopy for patients with melanoma, melanoma in situ, squamous cell carcinoma, squamous cell carcinoma in situ and basal cell carcinoma. Triage decisions were also more reliable with teledermoscopy and over 40% of the teledermoscopy patients could potentially have avoided face-to-face visits. Only 4 teledermoscopy referrals (0.4%) had to be excluded due to poor image quality. Smartphone teledermoscopy referrals allow for faster and more efficient management of patients with skin cancer as compared to traditional paper referrals.
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| 3. |
- Dahlén Gyllencreutz, Johan, et al.
(författare)
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Teledermoscopy images acquired in primary health care and hospital settings - a comparative study of image quality.
- 2018
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Ingår i: Journal of the European Academy of Dermatology and Venereology : JEADV. - : Wiley. - 1468-3083 .- 0926-9959. ; 32:6, s. 1038-1043
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of melanoma and non-melanoma skin cancer is increasing, which has also lead to an increase in referrals between primary health care (PHC) and dermatology departments, putting a strain on healthcare services. Teledermoscopy (TDS) referrals from PHC can improve the triage process for patients with suspicious skin tumours, but the quality of the images included could potentially affect its usefulness.To critically appraise the quality of the dermoscopic images of a smartphone TDS system, by comparing the TDS referral images with images of the same tumours acquired at the department of dermatology.Two dermatologists rated the image quality of two image sets from 172 skin tumours separately. The dermatologists also decided on a main diagnosis, differential diagnoses and described the visible dermoscopic structures.The images acquired in PHC were rated as having slightly lower quality, but there was no significant difference. PHC images and dermatology images were of intermediate-to-high quality in 95.5%-97.7% and 96.5%-98.8%, respectively. There was no difference in agreement between the TDS diagnosis based on the two image sets with the final clinical or histopathological diagnosis. Most image pairs (81.4% and 83.7%) received the same main diagnosis by the two evaluators. When this was not the case, the most common reasons were poor focus, excessive pressure applied when acquiring the image or inadequate amount of zoom.TDS performed in PHC with a smartphone-based system does not seem to negatively affect the usefulness of TDS referrals. Thus, physicians at PHC do not necessarily need to be trained photographers to ensure adequate TDS image quality. Knowledge about technical difficulties could however be used when training PHC staff, to improve the image quality further.
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| 4. |
- Menzies, Scott W, et al.
(författare)
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Dermoscopic evaluation of amelanotic and hypomelanotic melanoma.
- 2008
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Ingår i: Archives of dermatology. - : American Medical Association (AMA). - 1538-3652 .- 0003-987X. ; 144:9, s. 1120-7
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Tidskriftsartikel (refereegranskat)abstract
- To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma.
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| 5. |
- Menzies, Scott W, et al.
(författare)
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Dermoscopic Evaluation of Nodular Melanoma.
- 2013
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Ingår i: JAMA dermatology (Chicago, Ill.). - : American Medical Association (AMA). - 2168-6084 .- 2168-6068. ; 149:6, s. 699-709
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. OBJECTIVE To determine the dermoscopy features of NM. DESIGN Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes. SETTING Predominantly hospital-based clinics from 5 continents. MAIN OUTCOME MEASURES Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. RESULTS Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. CONCLUSIONS AND RELEVANCE When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.
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| 6. |
- Paoli, John, 1975, et al.
(författare)
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Response to the letter by Leitch et al.
- 2015
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Ingår i: Acta dermato-venereologica. - 1651-2057. ; 95:7, s. 870-1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Terstappen, Karin, 1967
(författare)
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Aspects on in vivo imaging techniques for diagnostics of pigmented skin lesions
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abstract Problem: Non-invasive diagnostic techniques to facilitate diagnosis of pigmented skin lesions (PSL) are being developed. Dermoscopy and SIAscopy are two such techniques, and they are evaluated in this thesis. Aims: Pp I: To investigate if primary care physicians (PCPs) improve their ability to diagnose melanoma using dermoscopy after a short education intervention. Pp II: To describe relevant morphological features of pigmented basal cell carcinomas (BCCs) using dermoscopy and to create a diagnostic method based on these findings. Pp III: To evaluate if SIAscopy could be used to diagnose pigmented BCCs. Pp IV: i) To find out if SIAscopic findings topographically correlated with histopathological findings of melanoma; ii) if SIAscopy could give a topographic indication of the localisation of maximum tumour thickness, iii) provide a guide for appropriate sectioning of the specimen for histopathological evaluation. Methods: Pp I: The diagnostic accuracy for melanoma and non-melanoma PSLs were tested among 74 PCPs, divided into an education intervention group and a control group. Both groups were re-tested after the education intervention. Pp II: 426 dermoscopic images of pigmented BCCs, melanomas and benign PSLs were scored for dermoscopic features. Based on the results an algorithm was derived. Pp III: 21 pigmented BCCs were analysed regarding dermoscopic and SIAscopic findings. Pp IV: 60 PSLs, i.e. 29 invasive melanomas, 13 melanoma in situ and 18 benign PSLs, showing positive SIAscopic findings were included. Topographic comparisons were made between SIAscopic findings and histopahology. Results: Pp I: There was a significant improvement in sensitivity for melanoma diagnosis among PCPs who were educated in dermoscopy. Pp II: A dermoscopic algorithm for diagnosing pigmented BCCs was created. The algorithm had a sensitivity of 93% for the diagnosis of pigmented BCCs, a specificity of 89% for invasive melanoma and 92% for benign pigmented skin lesions. Pp III: The same SIAscopic features that had previously been shown to be frequent in melanomas, were seen in pigmented BCCs. Using dermoscopy 90% of the pigmented BCCs were correctly diagnosed. Pp IV: In only 11 of 29 invasive melanomas the SIAgraphs topographically matched the area of invasion on histology. A high concentration of dermal melanin was the SIAscopic signal with best correlation to melanoma invasion, although it also proved to have low specificity. Conclusions: Pp I: Dermoscopy significantly improves sensitivity for melanoma when used by primary care physicians, after a short education intervention on dermoscopy. Pp II: A robust dermoscopy algorithm that allows the diagnosis of pigmented BCCs from invasive melanoma and benign pigmented skin lesions has been developed. Pp III: SIAscopy has no advantage over dermoscopy when diagnosing pigmented basal cell carcinoma, and can be misleading if the examiner has little or no knowledge of dermoscopy. Pp IV: Information regarding microscopic structure and architecture given by the SIAscope does not represent reliable diagnostic information related to the lesions internal structure, when compared to histopathology. Therefore SIAscopy cannot be used as a guide for localising the maximum tumour thickness when performing histopathological examination. Key words: Melanoma, pigmented nevi, basal cell carcinoma, differential diagnosis, dermoscopy, spectrophotometric intracutaneous analysis, pathology ISBN 978-91-628-7547-3
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| 8. |
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| 9. |
- Terstappen, Karin, 1967, et al.
(författare)
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Pigmented Basal Cell Carcinoma - Comparing the Diagnostic Methods of SIAscopy and Dermoscopy
- 2007
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Ingår i: Acta Derm Venereol. ; 87:3, s. 238-42
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Tidskriftsartikel (refereegranskat)abstract
- "Pigmented basal cell carcinomas can be difficult to distinguish clinically from melanoma. Dermoscopy has proven to be useful in the differential diagnosis of the two tumour types. SIAscopy (Spectrophotometric intracutaneous analysis) is a fairly new technique of imaging pigmented skin lesions that has been presented previously as a useful tool in diagnosing melanoma. The aim of this study was to evaluate whether SIAscopy can be useful in diagnosing pigmented basal cell carcinomas. Twenty-one pigmented basal cell carcinomas were analysed, comparing dermoscopic and SIAscopic findings. The results, in this limited setting, show that SIAscopy has no advantages over dermoscopy when diagnosing pigmented basal cell carcinomas. On the contrary, pigmented basal cell carcinomas show, in SIAscopy, similar features to those previously reported for melanoma. "
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| 10. |
- Terstappen, Karin, 1967
(författare)
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Pigmentierte basalzellkarzinome.
- 2003
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Ingår i: Dermatoskopie von Hauttumoren.. - Darmstadt, Tyskland : Steinkopff Verlag.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 11. |
- Terstappen, Karin, 1967, et al.
(författare)
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Poor correlation between spectrophotometric intracutaneous analysis and histopathology in melanoma and nonmelanoma lesions.
- 2013
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Ingår i: Journal of Biomedical Optics. - 1083-3668 .- 1560-2281. ; 18:6
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT. Spectrophotometric intracutaneous analysis (SIAscopy) is an imaging technique developed for diagnostics of pigmented skin lesions. By image analysis, the displayed images indicate the potential distribution and position of melanin, blood, and collagen within the lesion. A topographic comparison was performed between SIAscopic findings and histopathology. In total, 60 patients with suspicious pigmented skin lesions were included. The lesions were SIAscopically imaged and documented before excision and histopathological preparation. Topographical comparisons between SIAscopy findings and histopathology were made. A sensitivity and specificity of 24% and 84%, respectively, were obtained for invasive melanomas. The positive and negative predicted values were 58% and 54%, respectively. The features indicating dermal melanin, blood displacement and collagen holes did only show "no" to "slight" agreement with histopathology, i.e., κ≤0.21. It was concluded that (i)SIAscopy-based diagnosis has low diagnostic accuracy for melanoma, (ii)single SIAscopic features do not provide reliable diagnostic information relating to the lesions internal structure on histopathology examination and (iii)SIAscopy cannot be used as a guide for localizing the maximum tumor thickness when performing the histopathological examination. The importance of validating new optical tools for tumor diagnostics with histopathological findings was demonstrated.
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