| 1. |
- Munem, Marwa, et al.
(författare)
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Chemical imaging of aggressive basal cell carcinoma using time-of-flight secondary ion mass spectrometry.
- 2018
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Ingår i: Biointerphases. - : American Vacuum Society. - 1559-4106 .- 1934-8630. ; 13:3
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Tidskriftsartikel (refereegranskat)abstract
- A set of basal cell carcinoma samples, removed by Mohs micrographic surgery and pathologically identified as having an aggressive subtype, have been analyzed using time-of-flight secondary ion mass spectrometry (SIMS). The SIMS analysis employed a gas cluster ion beam (GCIB) to increase the sensitivity of the technique for the detection of intact lipid species. The GCIB also allowed these intact molecular signals to be maintained while surface contamination and delocalized chemicals were removed from the upper tissue surface. Distinct mass spectral signals were detected from different regions of the tissue (epidermis, dermis, hair follicles, sebaceous glands, scar tissue, and cancerous tissue) allowing mass spectral pathology to be performed. The cancerous regions of the tissue showed a particular increase in sphingomyelin signals that were detected in both positive and negative ion mode along with increased specific phosphatidylserine and phosphatidylinositol signals observed in negative ion mode. Samples containing mixed more and less aggressive tumor regions showed increased phosphatidylcholine lipid content in the less aggressive areas similar to a punch biopsy sample of a nonaggressive nodular lesion.
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| 2. |
- Ulrich, C, et al.
(författare)
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The European Status Quo in legal recognition and patient-care services of occupational skin cancer.
- 2016
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Ingår i: Journal of the European Academy of Dermatology and Venereology : JEADV. - : Wiley. - 1468-3083 .- 0926-9959. ; 30:Suppl 3, s. 46-51
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Tidskriftsartikel (refereegranskat)abstract
- Skin cancer is the most common malignancy in Caucasian populations worldwide and ultraviolet radiation (UVR) is known for being the number one carcinogen. As, especially in outdoor workers, UVR is an inevitable carcinogen, the prevention and management of UVR-related skin cancers in these at-risk populations represent a collective challenge for dermatologists and healthcare policymakers likewise.
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| 3. |
- Alonso-Castro, Leticia, et al.
(författare)
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The effect of pulsed dye laser on high-risk basal cell carcinomas with response control by Mohs micrographic surgery
- 2015
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Ingår i: Lasers in medical science. - : Springer Science and Business Media LLC. - 1435-604X .- 0268-8921. ; 30:7, s. 2009-2014
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Tidskriftsartikel (refereegranskat)abstract
- Several reports have shown the effectiveness of pulsed dye laser (PDL) for the treatment of basal cell carcinoma (BCC). Most studies have focused on low-risk BCCs, but an important limitation has been the lack of histologic confirmation of the treatment results. The aim of this study was to assess the effectiveness of PDL in high-risk BCCs with complete histologic evaluation with Mohs micrographic surgery (MMS). Seven patients with high-risk BCCs located on the face were included. All tumors were treated with three sessions of PDL (595nm) at 4-week intervals. The tumor and 4mm of peripheral skin were treated with two stacked pulses with a 1-s delay, a fluence of 15J/cm(2), a pulse duration of 2ms, and a spot size of 7mm. MMS was performed at least 1month after the last PDL session including excisional tumor debulking prior to the first stage of MMS for standard histologic evaluation. Apparent complete clinical response was achieved in five of seven patients. MMS was finally performed in six patients, and clear margins were achieved after one stage of MMS. The histologic evaluation of the tumor debulking specimens showed complete clearance in four of six cases. One patient who did not undergo MMS showed a recurrence after 14months. This is the first pilot study that demonstrates that PDL can be effective for the treatment of high-risk BCCs. Until further scientific evidence is available, treatment of high-risk BCCs should include histologic confirmation of clearance.
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| 4. |
- Augustsson, Anna, et al.
(författare)
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Effects of a 1-Day Training Course in Dermoscopy Among General Practitioners.
- 2019
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Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 9:3, s. 195-199
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Tidskriftsartikel (refereegranskat)abstract
- General practitioners (GPs) are often the first point of contact for Swedish patients seeking medical advice for skin lesions of concern, but many lack training in dermoscopy.To examine the effects of a 1-day training course in dermoscopy among Swedish GPs.The intervention group consisted of GPs who underwent a 1-day training course in dermoscopy and a control group that did not undergo any education. Before the training course, the intervention group performed a test consisting of 30 dermoscopy cases including 9 different benign and malignant melanocytic and nonmelanocytic diagnoses. The participants then took the same test directly after the course and again after 6 months. The control group took the same test twice with a 6-month interval in between tests in order to avoid recall bias.Twenty-seven GPs in the intervention group took the test before and immediately after the course with an improvement of their median test scores by 8 points (13 vs 20 correct answers, P < 0.01). Eighteen participants also took the test a third time after 6 months with similar results compared with the second test (median scores of 20.5 vs 20.0, P = 0.3). In the control group, 16 persons preformed both tests with an improvement of their median score by 2 points (13.5 vs 15.5 correct answers, P = 0.06).The results of this study show positive effects on diagnostic accuracy in a test situation among GPs receiving a 1-day training course in dermoscopy.
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| 5. |
- Boixeda, P, et al.
(författare)
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Future Prospects in Dermatologic Applications of Lasers, Nanotechnology, and Other New Technologies. : Perspectivas de futuro en láseres, nuevas tecnologías y nanotecnología en dermatología.
- 2015
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Ingår i: Actas dermo-sifiliograficas. - : Elsevier BV. - 1578-2190 .- 0001-7310. ; 106:3, s. 168-179
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Tidskriftsartikel (refereegranskat)abstract
- We review novel technologies with diagnostic and therapeutic applications in dermatology. Among the diagnostic techniques that promise to become part of dermatologic practice in the future are optical coherence tomography, multiphoton laser scanning microscopy, Raman spectroscopy, thermography, and 7-T magnetic resonance imaging. Advances in therapy include novel light-based treatments, such as those applying lasers to new targets and in new wavelengths. Devices for home therapy are also appearing. We comment on the therapeutic uses of plasma, ultrasound, radiofrequency energy, total reflection amplification of spontaneous emission of radiation, light stimulation, and transepidermal drug delivery. Finally, we mention some basic developments in nanotechnology with prospects for future application in dermatology.
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| 6. |
- 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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| 7. |
- Ceder, Hannah, et al.
(författare)
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Evaluation of electrical impedance spectroscopy as an adjunct to dermoscopy in short-term monitoring of atypical melanocytic lesions.
- 2016
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Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 6:4, s. 1-6
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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.
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| 8. |
- Claeson, Magdalena, 1976, et al.
(författare)
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Lethal Melanomas: A Population-based Registry Study in Western Sweden from 1990 to 2014.
- 2017
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 97:10, s. 1206-1211
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Tidskriftsartikel (refereegranskat)abstract
- The incidence rates of thin melanomas (≤1 mm Breslow thickness) have increased in many fair-skinned populations, prompting a need to better identify patients with thin melanomas who will eventually die from the disease. This study aimed to describe the clinicopathological characteristics of lethal melanomas in Western Sweden, with a focus on thin lesions. Population-based data on invasive melanomas diagnosed during the years 1990 to 2014 were extracted from the Swedish Melanoma Registry, and linked to the Swedish Cause of Death Registry. The age-standardized incidence (US population 2000) of thin melanomas increased from 9.1×10-5 (95% confidence interval (95% CI) 8.5-9.8) to 21.3×10-5 (95% CI 20.4-22.1) during the study period. Thin melanomas comprised 55.2% of the total and contributed to 13.5% of all melanoma deaths. Non-ulcerated melanomas 0.76-1 mm and ulcerated melanomas 0.26-1.0 mm showed a poorer survival compared with other thin melanomas.
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| 9. |
- Claeson, Magdalena, 1976, et al.
(författare)
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Modelling the Future: System Dynamics in the Cutaneous Malignant Melanoma Care Pathway
- 2016
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 96:2, s. 181-185
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Tidskriftsartikel (refereegranskat)abstract
- Incidence rates for cutaneous malignant melanoma are increasing worldwide. Estimates of the future number of melanoma cases are important for strategic planning of the care pathway. The aim of this study was to use system dynamics modelling to evaluate the long-term effects of changes in incidence, population growth and preventive interventions. Historical data on invasive melanoma cases in Western Sweden from 1990 to 2006 were obtained. Using computer simulation software, a model estimating the accumulated number of melanoma cases for 2014 to 2023 was developed. Five future scenarios were designed: stable incidence, business-as-usual, 25% reduced patient's delay, 50% reduced doctor's delay, and a combination of the last 2, called improved overall secondary prevention. After 10 years, improved overall secondary prevention would have resulted in a 42% decrease in melanomas >4 mm and a 10% increase in melanomas ≤1 mm, compared with business-as-usual. System dynamics is a valuable tool, which can help policymakers choose the preventive interventions with the greatest impact.
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| 10. |
- Claeson, Magdalena, 1976, et al.
(författare)
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Multiple primary melanomas in Western Sweden; 1990-2013
- 2016
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Ingår i: 3rd International Conference on UV and Skin Cancer Prevention, Melbourne.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionIn Sweden, the incidence of cutaneous malignant melanoma rises yearly with 5.5% for men and 5.2% for women and has now reached world standard rates of 17.6 for men and 18.8 for women per 100,000 population. Over the past decades, the incidence of melanoma has been higher in Western Sweden than the national average. Previous international studies have shown that melanoma patients have an elevated risk of developing a new separate primary melanoma. This study aimed at describing multiple primary melanomas (MPMs) in Western Sweden with focus on the number of tumours detected, tumour characteristics and the time to diagnosis of a subsequent melanoma.MethodsData was extracted retrospectively from the Swedish Melanoma Registry and provided information on all invasive and in situ melanoma cases in Western Sweden (1.6 million inhabitants) from 1990 to 2013. Results Within the studied period, 12,152 patients developed 13,291 melanomas. 11,254 of the patients developed only a single primary melanoma. In total, 898 patients (7.4% of all melanoma patients) developed 2,037 MPMs. Preliminary results show that the median Breslow thickness for all invasive melanomas was below 1 mm. The median Breslow thickness for the MPMs was slightly thinner for the second and third invasive melanoma as compared to the first invasive melanoma. Further, there was a higher percentage of in situ tumours among the subsequent melanomas. The median time to diagnosis of a subsequent melanoma was approximately 3 years. DiscussionSubsequent primary melanomas in Western Sweden are most commonly diagnosed with a somewhat thinner Breslow thickness than the first primary melanoma. The comparatively high percentage of melanoma survivors developing MPMs and the short median time to diagnosis of a subsequent melanoma stresses the importance of follow-up for melanoma patients, particularly during the first years.
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