scholarly journals Accuracy of Store-and-Forward Teledermatology for the Diagnosis of Skin Cancer: The Nouvelle-Aquitaine Experience (Preprint)

2021 ◽  
Author(s):  
Colin Bui ◽  
Marie-Sylvie Doutre ◽  
Alain Taieb ◽  
Marie Beylot-Barry ◽  
Jean-Philippe Joseph ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Precancerous Lesion ◽  
Pathological Finding ◽  
Skin Lesions ◽  
University Hospital ◽  
Median Response ◽  
Day Range ◽  
Intervention Area ◽  
Store And Forward ◽  
The University

BACKGROUND In Nouvelle-Aquitaine (a French region with a population of almost 6 million), the density of dermatologists is less than 3.8/100,000 inhabitants. This lack of dermatological care is delaying diagnosis and management, especially for skin cancer. The SmartDerm Project is a store-and-forward (SAF) teledermatology platform for primary care in Nouvelle-Aquitaine providing dermatological counselling to general practitioners (GPs). OBJECTIVE The main objective was to determine the concordance between the diagnosis of skin cancer made by dermatologists and the pathologists’ diagnosis. METHODS GPs in 3 pilot departments of Nouvelle-Aquitaine (Lot-Et-Garonne, Deux-Sèvres, Creuse) sent their dermatology requests using their smartphone, via an app called PAACO/Globule; dermatologists at the University Hospital of Bordeaux answered within 48-72 hours. Consecutive cases of skin cancer suspected by the referent dermatologists during the intervention were included, if the result of biopsy interpreted by a certified pathologist was available at the time of the study. RESULTS Among the 1727 requests, 163 (9%) concerned a possible diagnosis of skin cancer and were eligible. For 61 cases, the histopathological findings were not available. Eventually, 93 patients with a total of 102 skin lesions were included. Median age was 75 years (range 26-97 years), with 53% women. The skin lesions had progressed for 8 months on average (range 0.5-36 months). The median response time was 1 day (range 0-61 days); 65 days (range 1-667 days) elapsed on average between the SAF opinion and the histological sample. Histopathology diagnosed 83 malignant lesions (57 basal cell carcinomas, 69%; 18 squamous cell carcinomas, 22%; 6 melanomas, 7%; 1 cutaneous lymphoma, 1%; 1 secondary location of a primary cancer, 1%), 1 precancerous lesion, and 18 benign lesions. The concordance between the opinion of the referent dermatologist and the final pathological finding was 83% for nonmelanocytic lesions and 67% for melanocytic lesions. CONCLUSIONS This study showed the reliability of SAF teledermatology in the diagnosis of skin cancer, comparable to literature data in the absence of dermatoscopy. The median delay of about two months between request and histology was an improvement compared to the delay of usual appointments in the intervention area. The lack of data for 61 patients showed that SAF telemedicine requires better coordination and follow-up, especially for the management of skin cancer. With this reservation in mind, teledermatology offers an alternative answer for the triage of patients with skin cancer residing in areas with low medical density.

scholarly journals Accuracy of Store-and-Forward Teledermatology for the Diagnosis of Skin Cancer: The Nouvelle-Aquitaine Experience

Iproceedings ◽  
10.2196/35404 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35404
Author(s):  
Colin Bui ◽  
Marie-Sylvie Doutre ◽  
Alain Taieb ◽  
Marie Beylot-Barry ◽  
Jean-Philippe Joseph ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Conflicts Of Interest ◽  
Precancerous Lesion ◽  
Pathological Finding ◽  
Skin Lesions ◽  
University Hospital ◽  
Median Response ◽  
Day Range ◽  
Intervention Area ◽  
Store And Forward

Background In Nouvelle-Aquitaine (a French region with a population of almost 6 million), the density of dermatologists is less than 3.8/100,000 inhabitants. This lack of dermatological care is delaying diagnosis and management, especially for skin cancer. The SmartDerm Project is a store-and-forward (SAF) teledermatology platform for primary care in Nouvelle-Aquitaine providing dermatological counselling to general practitioners (GPs). Objective The main objective was to determine the concordance between the diagnosis of skin cancer made by dermatologists and the pathologists’ diagnosis. Methods GPs in 3 pilot departments of Nouvelle-Aquitaine (Lot-Et-Garonne, Deux-Sèvres, Creuse) sent their dermatology requests using their smartphone, via an app called PAACO/Globule; dermatologists at the University Hospital of Bordeaux answered within 48-72 hours. Consecutive cases of skin cancer suspected by the referent dermatologists during the intervention were included, if the result of biopsy interpreted by a certified pathologist was available at the time of the study. Results Among the 1727 requests, 163 (9%) concerned a possible diagnosis of skin cancer and were eligible. For 61 cases, the histopathological findings were not available. Eventually, 93 patients with a total of 102 skin lesions were included. Median age was 75 years (range 26-97 years), with 53% women. The skin lesions had progressed for 8 months on average (range 0.5-36 months). The median response time was 1 day (range 0-61 days); 65 days (range 1-667 days) elapsed on average between the SAF opinion and the histological sample. Histopathology diagnosed 83 malignant lesions (57 basal cell carcinomas, 69%; 18 squamous cell carcinomas, 22%; 6 melanomas, 7%; 1 cutaneous lymphoma, 1%; 1 secondary location of a primary cancer, 1%), 1 precancerous lesion, and 18 benign lesions. The concordance between the opinion of the referent dermatologist and the final pathological finding was 83% for nonmelanocytic lesions and 67% for melanocytic lesions. Conclusions This study showed the reliability of SAF teledermatology in the diagnosis of skin cancer, comparable to literature data in the absence of dermatoscopy. The median delay of about two months between request and histology was an improvement compared to the delay of usual appointments in the intervention area. The lack of data for 61 patients showed that SAF telemedicine requires better coordination and follow-up, especially for the management of skin cancer. With this reservation in mind, teledermatology offers an alternative answer for the triage of patients with skin cancer residing in areas with low medical density. Conflicts of Interest None declared.

scholarly journals Activity of Skin Cancer Clinic at Martin University Hospital in 2017

2018 ◽  
Vol 18 (1) ◽  
pp. 21-29
Author(s):  
E Minarikova ◽  
M Smolarova ◽  
M Minarik
Keyword(s):  
Skin Cancer ◽  
Malignant Melanoma ◽  
Skin Lesions ◽  
Common Type ◽  
Upper Extremities ◽  
Breslow Thickness ◽  
University Hospital ◽  
Superficial Spreading ◽  
The University ◽  
Cancer Clinic

Abstract The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).

scholarly journals ESTUDO ANATOMOPATOLÓGICO DOS CASOS DE CÂNCER DE PELE NÃO MELANOMA ATENDIDOS NO HOSPITAL UNIVERSITÁRIO DA UNIVERSIDADE FEDERAL DO PIAUÍ/ Anatomopathological study of non-melanoma skin cancer treated at the University Hospital of the Federal University of Piauí

2021 ◽  
Vol 5 (2) ◽  
pp. 6-13
Author(s):  
João Victor Alves de Castro ◽  
Rafael De Deus Moura ◽  
Carla Riama Lopes de Pádua Moura ◽  
Aline Reis Ferro Braga ◽  
Andressa Marques Campelo de Carvalho ◽  
...  
Keyword(s):  
Skin Cancer ◽  
University Hospital ◽  
Non Melanoma Skin Cancer ◽  
The University ◽  
Melanoma Skin

O câncer de pele não melanoma (CPNM)  inclui, principalmente, o carcinoma basocelular (CBC) e carcinoma espinocelular (CEC). É o tipo mais incidente no Brasil em ambos os sexos, apresentando bom prognóstico. Trata-se de um estudo transversal que analisou o perfil clínico e histopatológico dos CPNM em um centro de referência em dermatologia no período de julho a dezembro de 2017. Realizou-se a revisão, por um dos patologistas do estudo com experiência em dermatopatologia, de todas as lâminas histopatológicas referentes aos casos e os dados complementares foram obtidos através de revisão dos prontuários. Foram encontrados 104 casos, distribuídos em 85 pacientes. 47,4% possuíam entre 60 e 79 anos, e 80,7% localizavam-se na região da cabeça e do pescoço. Os casos de CBC corresponderam a 89,4%, com o subtipo nodular predominando em 75,3% destes casos. 10,6% do total de casos corresponderam a CEC, apresentando grau moderadamente diferenciado em 65,6% desses. O procedimento de escolha para tratamento foi cirurgia excisional, em 96,2% dos casos. Observamos que 50% dos CBC e mais de 75% dos CEC apresentavam margens cirúrgicas abaixo das recomendações da maioria dos consensos, alertando para o possível aumento do risco de recidivas e para a importância de seguimento clínico rigoroso desses pacientes.

scholarly journals Screening of Cervical Cancer: Visual Inspection with Acetic Acid (VIA) and Site of Lesion Verified by Multiple Punch Biopsies

Folia Medica ◽  
2019 ◽  
Vol 61 (2) ◽  
pp. 289-295 ◽  
Author(s):  
Monira M. Gad ◽  
Salma B. Galal ◽  
Wafaa Helmy ◽  
Naela H Abd El-Fattah
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Screening Test ◽  
Visual Inspection ◽  
Precancerous Lesion ◽  
Intraepithelial Neoplasia ◽  
University Hospital ◽  
Egyptian Women ◽  
The Right ◽  
The University

Abstract Background: Cervical cancer is the tenth most frequent cancer in Egyptian women. The Papanicolaou screening test is not suitable for rural area as most follow-up consultations never take place. Aim: To evaluate visual inspection of the cervix with acetic acid as a screening test. Materials and methods: According to the inclusion criteria, women aged 25-60 years commuting to a gynecological out-patient clinic at the University Hospital went through a visual inspection of the cervix with acetic acid (VIA). Exclusion criteria were women below 25 years, unmarried, pregnant, menstruating, known to have cancer, having a precancerous lesion or a cervical operation. Multiple punch biopsies were done for all VIA positive cases and a subsample of the VIA negative cases underwent the same. Cervical intraepithelial neoplasia (CIN) was evaluated. In addition, the site of the lesion was assessed. SPSS was used for the statistical analysis. Results: Of the 379 screened women, 17.1% were found to be VIA positive. The sensitivity was found to be 91.3% (79.6%–96.5%) and the specificity 68.5% (57.1%–77.9%). Significantly more women with positive punch biopsies complained of contact bleeding than those with negative punch biopsies. CIN2 and CIN3 were mostly found (77.8%) in the right quadrant, while 74% of CIN1 was found in the lower right and left quadrant. Conclusion: VIA is weak as a test to stand alone but may need a combination with other indicators such as the location of the lesion on the right side of the cervix or contact bleeding. A combined indicator may detect precancerous cervix.

scholarly journals Follicular Epithelial Dysplasia as Hashimoto Thyroiditis-Related Atypia: a Series of 91 Specimens

2021 ◽  
Author(s):  
Ivana Kholová ◽  
David Kalfert ◽  
Jarkko Lintusaari ◽  
Erja Rajakorpi ◽  
Marie Ludvíková
Keyword(s):  
Papillary Carcinoma ◽  
Precancerous Lesion ◽  
Hashimoto Thyroiditis ◽  
Epithelial Dysplasia ◽  
University Hospital ◽  
Wide Range ◽  
Galectin 3 ◽  
Atypical Cells ◽  
The University ◽  
Follicular Epithelial

AbstractFollicular epithelial dysplasia (FED) is described as Hashimoto thyroiditis-related atypia and is thought to be a possible precancerous lesion. Dysplasia as an interface between normal state and carcinoma is described in a wide range of diseases and carcinogenesis chains. On the other hand, inflammation-related atypia and cancerogenesis is also widely studied. In this study, we retrospectively analyzed 91 specimens of thyroid gland surgical resections with FED during a 10-year-period at the university hospital pathology department. The study population consisted of 68 females and 15 males aged between 22 and 86 years. The preoperative cytology diagnoses had mainly been in the indeterminate categories with prevailing AUS/FLUS results in the FED-only group (p = 0.005) and suspicious for malignancy and malignant in the group with FED plus adjacent malignancy. The decision for surgery was malignancy related in 48.2% of the cases. The lesions were sized 0.1–3.5 mm and multifocal in 45.1% of the cases. Immunohistochemically, the atypical cells were cyclin D1-positive in 67.5%, galectin-3 in 72.7%, CK19 in 85.7%, and HBME-1 in 87.0% of cases. In conclusion, FED is suggested to be a pathogenetic link between inflammation-related atypia and papillary carcinoma and thus a premalignant precursor of papillary carcinoma in HT as 36.1% of the specimens contained also papillary carcinoma in the present study. Both histopathological nuclear features and the immunoprofile of FED are widely shared with that of papillary carcinoma.

scholarly journals Non-Melanoma Skin Cancer in Outdoor Workers: A Study on Actinic Keratosis in Italian Navy Personnel

2020 ◽  
Vol 17 (7) ◽  
pp. 2321 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Antonio Caputi ◽  
Enza Sabrina Silvana Cannone ◽  
Francesca Mansi ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Squamous Cell ◽  
Actinic Keratosis ◽  
Precancerous Lesion ◽  
Skin Lesions ◽  
Outdoor Workers ◽  
Exposed Skin ◽  
Non Melanoma Skin Cancer ◽  
Navy Personnel ◽  
Melanoma Skin

Occupational exposure to ultraviolet radiation is one of the main risk factors for non-melanoma skin cancer (NMSC) development. The most common variants of NMSC are basal cell carcinomas, squamous cell carcinomas, and actinic keratosis (AK). The latter is nowadays considered by most authors as an early squamous cell carcinoma rather than a precancerous lesion. Outdoor workers have a higher risk of developing NMSC because they spend most of the working day outside. The aim of this descriptive study was to assess the prevalence of skin lesions, especially AK, in a professional category of individuals exposed to ultraviolet (UV) radiation: the Italian Navy. From January to June 2016, a questionnaire and a total skin examination of 921 military personnel were administered by medical specialists (dermatologists) in seven different Italian Navy centres. AK was detected in 217 of 921 (23.5%) workers. Older age, outdoor occupation, longer working life, and fair skin seem to promote the development of AK. Of the 217 workers with AK, 187 (86.2%) had lesions in chronically sun-exposed skin areas. Italian Navy personnel have a high AK prevalence. Further studies are needed to investigate occupational hazards and their health effects among outdoor workers to promote protective behaviour and raise awareness of skin cancer.

Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽  
2004 ◽  
Vol 33 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Thalhammer ◽  
Aschwanden ◽  
Jeanneret ◽  
Labs ◽  
Jäger
Keyword(s):  
Current Literature ◽  
Vascular Complications ◽  
University Hospital ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Vascular Closure Device ◽  
Device Use ◽  
Arterial Stenoses ◽  
The University ◽  
Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

1993 ◽  
Vol 32 (05) ◽  
pp. 365-372 ◽  
Author(s):  
T. Timmeis ◽  
J. H. van Bemmel ◽  
E. M. van Mulligen
Keyword(s):  
Data Analysis ◽  
Clinical Research ◽  
Clinical Data ◽  
University Hospital ◽  
User Evaluation ◽  
Scientific Staff ◽  
Medical Institutions ◽  
Clinical Data Analysis ◽  
Research Problems ◽  
The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

Sharing of Worldwide Spread Knowledge Using Hypermedia Facilities & Fast Communication Protocols (Mosaic and World Wide Web): The Example of ExPASy

1995 ◽  
Vol 34 (01/02) ◽  
pp. 75-78 ◽  
Author(s):  
R. D. Appel ◽  
O. Golaz ◽  
Ch. Pasquali ◽  
J.-C. Sanchez ◽  
A. Bairoch ◽  
...  
Keyword(s):  
World Wide Web ◽  
World Wide ◽  
Relevant Literature ◽  
Communication Protocols ◽  
Laboratory Data ◽  
Central Element ◽  
University Hospital ◽  
New Information ◽  
The University ◽  
Link Information

Abstract:The sharing of knowledge worldwide using hypermedia facilities and fast communication protocols (i.e., Mosaic and World Wide Web) provides a growth capacity with tremendous versatility and efficacy. The example of ExPASy, a molecular biology server developed at the University Hospital of Geneva, is striking. ExPASy provides hypermedia facilities to browse through several up-to-date biological and medical databases around the world and to link information from protein maps to genome information and diseases. Its extensive access is open through World Wide Web. Its concept could be extended to patient data including texts, laboratory data, relevant literature findings, sounds, images and movies. A new hypermedia culture is spreading very rapidly where the international fast transmission of documents is the central element. It is part of the emerging new “information society”.

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