| 1. |
- Kantere, Despoina, et al.
(author)
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Anti-Stokes fluorescence from endogenously formed protoporphyrin IX - Implications for clinical multiphoton diagnostics.
- 2013
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In: Journal of biophotonics. - : Wiley. - 1864-0648 .- 1864-063X. ; 6:5, s. 409-415
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Journal article (peer-reviewed)abstract
- Multiphoton imaging based on two-photon excitation is making its way into the clinics, particularly for skin cancer diagnostics. It has been suggested that endogenously formed protoporphyrin IX (PpIX) induced by aminolevulinic acid or methylaminolevulinate can be applied to improve tumor contrast, in connection to imaging of tissue autofluorescence. However, previous reports are limited to cell studies and data from tissue are scarce. No report shows conclusive evidence that endogenously formed PpIX increases tumor contrast when performing multiphoton imaging in the clinical situation. We here demonstrate by spectral analysis that two-photon excitation of endogenously formed PpIX does not provide additional contrast in superficial basal cell carcinomas. In fact, the PpIX signal is overshadowed by the autofluorescent background. The results show that PpIX should be excited at a wavelength giving rise to one-photon anti-Stokes fluorescence, to overcome the autofluorescent background. Thus, this study reports on a plausible method, which can be implemented for clinical investigations on endogenously formed PpIX using multiphoton microscopy (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).
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| 2. |
- Munem, Marwa, et al.
(author)
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Chemical imaging of aggressive basal cell carcinoma using time-of-flight secondary ion mass spectrometry.
- 2018
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In: Biointerphases. - : American Vacuum Society. - 1934-8630 .- 1559-4106. ; 13:3
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Journal article (peer-reviewed)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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| 3. |
- Nilsson, Kelly Dimovska, et al.
(author)
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TOF-SIMS imaging reveals tumor heterogeneity and inflammatory response markers in the microenvironment of basal cell carcinoma
- 2020
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In: Biointerphases. - : American Vacuum Society. - 1934-8630 .- 1559-4106. ; 15:4
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Journal article (peer-reviewed)abstract
- Basal cell carcinoma (BCC) is the most common skin malignancy. In fact, it is as common as the sum of all other skin malignancies combined and the incidence is rising. In this focused and histology-guided study, tissue from a patient diagnosed with aggressive BCC was analyzed by imaging mass spectrometry in order to probe the chemistry of the complex tumor environment. Time-of-flight secondary ion mass spectrometry using a (CO2)(6 k)(+)gas cluster ion beam allowed a wide range of lipid species to be detected. Their distributions were then imaged in the tissue that contained small tumor islands that were histologically classified as more/less aggressive. Maximum autocorrelation factor (MAF) analysis highlighted chemical differences between the tumors and the surrounding stroma. A closer inspection of the distribution of individual ions, selected based on the MAF loadings, showed heterogeneity in signal between different microtumors, suggesting the potential of chemically grading the aggressiveness of each individual tumor island. Sphingomyelin lipids were found to be located in stroma containing inflammatory cells.
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| 4. |
- Ulrich, C, et al.
(author)
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The European Status Quo in legal recognition and patient-care services of occupational skin cancer.
- 2016
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In: 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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Journal article (peer-reviewed)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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| 5. |
- Al-Ali, Fatima, et al.
(author)
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Attitudes Towards Artificial Intelligence Among Dermatologists Working in Saudi Arabia.
- 2023
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In: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 13:1
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Journal article (peer-reviewed)abstract
- Artificial intelligence (AI) and its applications are among the most discussed modern technologies today. Despite the rapidly expanding use of AI in medicine, and specifically in dermatology, only a few studies have studied the attitude of physicians toward AI.To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi Arabia.A cross-sectional survey was done among dermatologists in Saudi Arabia. Questionnaires were distributed through several online channels.Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong potential for AI in the automated detection of skin diseases based on dermatological clinical images (50.9%), dermoscopic images (66.6%) and within dermatopathology (66.6%). In regard to results of attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology, respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and human dermatologists (39.6%) in the future. Age did not impact the overall attitude of dermatologists.Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology and medicine. However, dermatologists believe that AI will not replace humans in the future.
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| 6. |
- Alonso-Castro, Leticia, et al.
(author)
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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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In: Lasers in medical science. - : Springer Science and Business Media LLC. - 1435-604X .- 0268-8921. ; 30:7, s. 2009-2014
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Journal article (peer-reviewed)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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| 7. |
- Andersson, Eva M., 1968, et al.
(author)
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Incidence of cutaneous squamous cell carcinoma in coastal and inland areas of Western Sweden.
- 2011
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In: Cancer epidemiology. - : Elsevier BV. - 1877-783X .- 1877-7821. ; 35:6
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Journal article (peer-reviewed)abstract
- The incidence of squamous cell carcinoma (SCC) has increased in recent decades, both in Sweden and worldwide. The aim of this study was to investigate the development of SCC over time (1970-2007) in the western part of Sweden (WS), with emphasis on the incidence trends on the coast and in the inland areas.
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| 8. |
- Augustsson, Anna, et al.
(author)
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Effects of a 1-Day Training Course in Dermoscopy Among General Practitioners.
- 2019
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In: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 9:3, s. 195-199
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Journal article (peer-reviewed)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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| 9. |
- Bendsoe, N., et al.
(author)
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A Non-Interventional Study on Vismodegib for Basal Cell Carcinoma in Swedish Patients
- 2023
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In: Dermatology Practical & Conceptual. - : Mattioli1885. - 2160-9381. ; 13:2
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Journal article (peer-reviewed)abstract
- Introduction: Real-life data on vismodegib in advanced basal cell carcinoma (aBCC) are limited. Optimal treatment duration is left to the discretion of the physician.Objectives: To assess the effectiveness, safety and treatment pattern for vismodegib in aBCC in clinical practice.Methods: In this multicenter, non-interventional, prospective study, 49 Swedish patients planned for vismodegib treatment were included. The treatment pattern observed was treatment until remission, allowing unlimited discontinuations/pauses.Results: The majority of patients (93.8%), discontinued at least once during the study. Compared to earlier studies there was a decrease of more than 2 months with actual drug intake, reducing the patients burden and costs, at the same time as a high number of responses were seen (87.8%). Median progression-free-survival was 16.7 months, and 90% of the patients were alive at 13.3 months. Ten patients were re-challenged with vismodegib at recurrence or progression, resulting in five partial remissions and three complete remissions.Conclusions: Clinical response rates with vismodegib for aBCC were comparable to those of similar trials despite a shorter and more intermittent treatment duration. The majority of re-challenges lead to partial or complete remissions.
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| 10. |
- Berglund, Sofia, et al.
(author)
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Diagnostic accuracy and safety of short-term teledermoscopic monitoring of atypical melanocytic lesions
- 2020
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In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 34:6, s. 1233-1239
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Journal article (peer-reviewed)abstract
- Background: Short-term dermoscopic monitoring (STDM) of atypical melanocytic lesions (AML) after 3.0–4.5months can be used to detect featureless melanomas without performing countless unnecessary excisions of nevi. Recently, short-term teledermoscopic monitoring (STTM) was incorporated into the STDM clinical routine at Sahlgrenska University Hospital in Gothenburg, Sweden. Follow-up images for STTM were taken by an assistant nurse with subsequent teledermoscopic assessment by a dermatologist. Objectives: The purpose of this study was to evaluate the diagnostic accuracy and safety of STTM. Methods: In this retrospective observational study, data from electronic health records of patients with teledermoscopically monitored AMLs were explored. The number of changed and excised AMLs and their histopathological diagnoses were recorded. The excised AMLs were categorized into three subgroups according to when they changed and were excised: (i) following STTM, (ii) after planned long-term follow-up or (iii) after unplanned long-term follow-up. Results: A total of 686 patients with 883 AMLs were monitored with STTM. Sixty-two AMLs (7.0%) were excised following STTM, 14 (1.6%) after planned long-term follow-up and 10 (1,1%) after unplanned long-term follow-up. Twenty-one melanomas were detected using STTM, three after planned long-term follow-up and three after unplanned long-term follow-up. All melanomas were insitu (n=20) or thin and non-ulcerated (n=7; median Breslow thickness 0.4mm, range 0.3–0.8mm). The sensitivity for the diagnosis of melanoma by means of STTM with the option of additional planned follow-up was 88.9%, and the specificity was 93.9%. The number of AMLs needed to monitor in order to detect one melanoma with the STTM routine was 32.7, and the number needed to excise was 3.2. Conclusions: STTM of AMLs was safe and allowed for high diagnostic accuracy. All detected melanomas were insitu or thin and non-ulcerated. Furthermore, a considerable number of unnecessary excisions were spared. © 2019 European Academy of Dermatology and Venereology
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