scholarly journals Clinico-histopathological correlation of pigmented skin lesions: A hospital based study at BPKIHS

2019 ◽  
Vol 9 (2) ◽  
pp. 1550-1554
Author(s):  
Isha Bohra ◽  
Punam Paudyal ◽  
Anju Pradhan ◽  
Dhan Kesar Khadka
Keyword(s):  
Malignant Tumors ◽  
Skin Lesions ◽  
Pathological Examination ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Melanocytic Lesions ◽  
Benign Pathology ◽  
Seborrhoeic Keratosis ◽  
Pigmented Skin Lesions ◽  
Age Range

Background: Pigmented skin lesions refers to melanocytic as well as nonmelanocytic lesions. Pigmentation is not just a cosmetic deformity but can also reflect underlying benign pathology as nevi or malignant lesions as melanoma. With this study we intend to evaluate the spectrum of pigmented skin lesions and to correlate the clinical diagnosis with the histological diagnosis. Materials and Methods: This is a hospital based cross sectional descriptive study where clinicohistopathological evaluation of 46 cases of pigmented skin lesions were analyzed on paraffin embedded tissue sections for a duration of 1 year at the Department of Pathology, B. P. Koirala Institute of Health Sciences. Results: Out of the 46 cases evaluated there were 32 cases of melanocytic lesions comprising of benign melanocytic nevi (n=27), malignant melanoma (n=5) and 14 cases of nonmelanocytic lesions including basal cell carcinoma and seborrhoeic keratosis (5 cases each). Angiokeratoma (n=1), sebaceous hyperplasia (n=1), trichoepitheloma (n=1) and venous haemangioma (n=1). The age range was from 8-83 years with slight female predominance (52.2%) and the most common site involved was head and neck (58.7%). 76.1% of the patients belonged to the Terai region. Clinicohistopathological correlation showed positive correlation in 26 cases (56.5%) and negative correlation in 20 cases (43.5%). Conclusions: Pigmented skin lesions are common presenting problem, while majority are benign a small minority can be malignant. So, clinically pigmented skin lesions should be submitted for pathological examination in order not to miss a small percentage of malignant tumors and to differentiate melanocytic lesions from its nonmelanocytic mimickers.

scholarly journals The Development of a Skin Cancer Classification System for Pigmented Skin Lesions Using Deep Learning

Biomolecules ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1123 ◽  
Author(s):  
Shunichi Jinnai ◽  
Naoya Yamazaki ◽  
Yuichiro Hirano ◽  
Yohei Sugawara ◽  
Yuichiro Ohe ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Malignant Tumors ◽  
Skin Lesions ◽  
Training Dataset ◽  
Clinical Image ◽  
Benign Tumors ◽  
Clinical Images ◽  
Predictive Values ◽  
Test Dataset ◽  
Pigmented Skin Lesions

Recent studies have demonstrated the usefulness of convolutional neural networks (CNNs) to classify images of melanoma, with accuracies comparable to those achieved by dermatologists. However, the performance of a CNN trained with only clinical images of a pigmented skin lesion in a clinical image classification task, in competition with dermatologists, has not been reported to date. In this study, we extracted 5846 clinical images of pigmented skin lesions from 3551 patients. Pigmented skin lesions included malignant tumors (malignant melanoma and basal cell carcinoma) and benign tumors (nevus, seborrhoeic keratosis, senile lentigo, and hematoma/hemangioma). We created the test dataset by randomly selecting 666 patients out of them and picking one image per patient, and created the training dataset by giving bounding-box annotations to the rest of the images (4732 images, 2885 patients). Subsequently, we trained a faster, region-based CNN (FRCNN) with the training dataset and checked the performance of the model on the test dataset. In addition, ten board-certified dermatologists (BCDs) and ten dermatologic trainees (TRNs) took the same tests, and we compared their diagnostic accuracy with FRCNN. For six-class classification, the accuracy of FRCNN was 86.2%, and that of the BCDs and TRNs was 79.5% (p = 0.0081) and 75.1% (p < 0.00001), respectively. For two-class classification (benign or malignant), the accuracy, sensitivity, and specificity were 91.5%, 83.3%, and 94.5% by FRCNN; 86.6%, 86.3%, and 86.6% by BCD; and 85.3%, 83.5%, and 85.9% by TRN, respectively. False positive rates and positive predictive values were 5.5% and 84.7% by FRCNN, 13.4% and 70.5% by BCD, and 14.1% and 68.5% by TRN, respectively. We compared the classification performance of FRCNN with 20 dermatologists. As a result, the classification accuracy of FRCNN was better than that of the dermatologists. In the future, we plan to implement this system in society and have it used by the general public, in order to improve the prognosis of skin cancer.

scholarly journals Early diagnosis of melanoma by surface microscopy (dermatoscopy)

1996 ◽  
Vol 114 (4) ◽  
pp. 1220-1221 ◽  
Author(s):  
Francisco Macedo Paschoal
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Simple Technique ◽  
Skin Lesions ◽  
Accurate Diagnosis ◽  
Diagnostic Sensitivity ◽  
Melanocytic Lesions ◽  
Surface Microscopy ◽  
Pigmented Skin Lesions

The main objective of surface microscopy is the early and accurate diagnosis of melanoma in its initial phases of evolution and infiltration. Since the development of the dermatoscope in the 1990's, surface microscopy has become a simple technique. Differential diagnosis of pigmented skin lesions can be achieved with a diagnostic sensitivity of about 90 percent, and the proper differentiation of pigmented melanocytic and non-melanocytic lesions, and malignant and benign melanocytic lesions, may also be safely determined.

Dermoscopy in Pigmented Squamous Cell Carcinoma

2009 ◽  
Vol 13 (6) ◽  
pp. 326-329 ◽  
Author(s):  
Vincenzo de Giorgi ◽  
Barbara Alfaioli ◽  
Federica Papi ◽  
Agata Janowska ◽  
Marta Grazzini ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Potential Role ◽  
Diagnostic Errors ◽  
Skin Lesions ◽  
Melanocytic Lesion ◽  
Melanocytic Lesions ◽  
Pigmented Skin Lesions

Background: The diagnosis of squamous cell carcinoma (SCC) is, generally, a clinical diagnosis, but in some cases, when the lesion is pigmented, as in our case, the differential diagnosis between pigmented SCC and other pigmented skin lesions, in particular melanocytic lesions, is difficult. Dermoscopy may improve the early diagnosis of SCC and thus play a role in its preoperative classification. However, its potential role has been hampered so far by the fact that little is known about the dermoscopic features of pigmented SCC. Objective: We report the case of a rare pigmented SCC dermoscopically mimicking a melanocytic lesion whose dermoscopic features have been investigated. Conclusion: On the basis of the literature and our experience, pigmented SCC can present dermoscopic features typical of melanocytic lesions, such as radial streaks, globules, and homogeneous blue pigmentation, and can lead dermatologists to diagnostic errors.

scholarly journals Melanocytic or Not? Dermoscopy and Reflectance Confocal Microscopy for Lesions Difficult to Diagnose: A Cross-Sectional Diagnostic Accuracy Study

2021 ◽  
pp. e2021127
Author(s):  
Camila Scharf ◽  
Giuseppe Argenziano ◽  
Gabriella Brancaccio ◽  
Gaetano Licata ◽  
Andrea Ronchi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Confocal Microscopy ◽  
Diagnostic Accuracy ◽  
High Specificity ◽  
Skin Lesions ◽  
Reflectance Confocal Microscopy ◽  
Melanocytic Lesion ◽  
Cross Sectional ◽  
Present Sample ◽  
Melanocytic Lesions

Background: Different techniques for non-invasive skin examination and early diagnosis of skin lesions are available nowadays, being dermoscopy and reflectance confocal microscopy (RCM) the most diffused ones. Several studies supported the complementary use of dermoscopy and RCM that improves diagnostic accuracy when dealing with melanocytic lesions. Objectives: To analyze RCM diagnostic accuracy in the differential diagnosis between melanocytic and non-melanocytic lesions. Methods: This is a cohort selected cross-sectional study conducted at the Dermatology Unit of the University of Campania L. Vanvitelli, Naples, Italy, from 2012 to 2020. We searched the image database for all excised lesions for which the clinical and dermatoscopic differential diagnosis was between melanocytic and non-melanocytic and for which an RCM examination was performed. Sensitivity, specificity, and diagnostic accuracy values ​​were estimated. Results: The study included 53 cases that were found to have disagreement between clinical, histological and RCM diagnosis, of which, in 31 cases the differential diagnosis was melanocytic vs non-melanocytic lesion. The RCM reached a specificity of 87% (95% CI: 0.73-1) and a sensitivity of 62.5% (95% CI: 0.29-0.96) in the present sample. Diagnostic accuracy was 80.6% (95% CI: 0.67-0.94). Conclusion: RCM has a high specificity in differentiating between difficult-to-diagnose melanocytic and non-melanocytic lesions.

scholarly journals Pigmented Lesions of Skin: A Histopathologic Experience at a Tertiary Care Center in Central Nepal

2021 ◽  
Vol 17 (1) ◽  
pp. 1-9
Author(s):  
Binita Goyal ◽  
Suman Rai ◽  
Mamata Sedhain ◽  
Pratigya Subedi
Keyword(s):  
Cell Carcinoma ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Care Center ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Pigmented Lesions ◽  
Pigmented Skin Lesions

Introduction Pigmented skin lesions refer to lesions that are brown, black or blue in color. These are not always melanocytic in origin. Keratinocytic, vascular or reactive pigmentation in other lesions can also appear pigmented. The main aim of the study was to see the histopathological spectrum and objective was to compare clinical and histopathological diagnoses in pigmented skin lesions. Methods This descriptive study was carried out on 43 pigmented skin lesions that were biopsied over a 1 and half year period from Jan 2018 to June 2019 in College of Medical Sciences and Teaching Hospital. Results Age of the patient ranged from 10 to 88 years and mean±SD was 42.02±19.73 years. There were 21 (48.8%) males and 22 (51.2%) females with a male female ratio 0.9:1. Melanocytic nevus was the most common histopathological diagnosis (11 cases, 25.6%). Reactive pigmentation was seen in 20 (46.5%) cases. Malignant cases comprised 6 (14.0%) cases which included 2 (4.7%) cases of melanoma, 2 (4.7%) cases of pigmented basal cell carcinoma and 1 (2.3%) case each of basaloid squamous cell carcinoma and trichoblastic carcinoma each. Clinicopathological agreement could be seen in 32 (74.4%) cases. However, malignancy was clinically suspected in only half of histologically diagnosed cases. Conclusions Melanocytic nevi were the most common pigmented lesions diagnosed. Not all pigmented lesions are melanocytic in origin. Malignant tumors can sometimes appear deceptively benign and also tumors other than melanoma can be pigmented. Hence, histopathological examination remains the gold standard in diagnosing these conditions and guiding appropriate management. Keywords: melanocytic; melanoma; nevus; pigmented.  

scholarly journals Prevalence and Predictors of Use of Herbal Medication for Dermatological Conditions in South-South Nigeria

2021 ◽  
pp. 12-21
Author(s):  
Bolaji I. Otike-Odibi ◽  
Enu Timipre ◽  
Dasetima Altraide
Keyword(s):  
Skin Lesions ◽  
The Body ◽  
Cross Sectional ◽  
Female Ratio ◽  
Dermatology Clinic ◽  
Port Harcourt ◽  
High Prevalence ◽  
The Face ◽  
Cross Sectional Design ◽  
Age Range

Aims:  To assess the prevalence of herbal use and factors that predispose (predictors). dermatology patients to the use of herbal preparations and medications at the Dermatology clinic of University of Port-Harcourt Teaching Hospital (UPTH), Port-Harcourt, Nigeria. Study Design: A descriptive cross sectional design was used. Place and Duration of Study: The Dermatology clinic in UPTH over a four-month period. (September 2020- December 2020). Methodology: Data was collected using an interviewer administered questionnaire designed by the study researchers. It consisted of demographic characteristics, dermatologic history and participant’s awareness, use, duration of use, outcome, side-effects and cost of remedy to herbal medications as well as overall satisfaction. Results: One hundred and seventy patients were recruited for the study over the four-month period. The age range was 1 to 75 years with mean age of 30.8years ±14.9   with a male to female ratio of 1:1.7. There were females 63.5%, with participants being mostly in their third decade 28.2%, single 65.3% with tertiary level of education 64.1%.  Most dermatologic lesions started as rashes 50.6%, itching 48.8% with the hands (48.2%) and the legs (47.6%) being the most affected parts of the body. 85% of participants were aware of herbal use and 37.6% had used them to treat dermatological lesions. Some herbs used include “gbogbonise”, ginger, garlic, paw-paw leaf, lemon, lime moringa and turmeric. Predictors for herbal use were lesions on the face and duration of skin lesions for (1-5 years).    Conclusion: There is a high prevalence of herbal use for dermatologic conditions in this locality with a female preponderance. Healing of dermatological lesions with the herbs was not recorded.  Duration of skin lesion and lesion location on the face were identified predictors of herbal use for dermatologic conditions in this locality. This study is important because it shows that people are interested in herbal treatments and8 are looking for suitable alternatives to medicinal oral and topical therapies.   

scholarly journals COMMON PIGMENTED SKIN LESIONS

2018 ◽  
Vol 25 (01) ◽  
pp. 78-83
Author(s):  
Amjad Ali Khan ◽  
Abdul Shaheed Asghar ◽  
Israr Ahmed Akhund ◽  
Muhammad Ishaq
Keyword(s):  
Clinical Diagnosis ◽  
Malignant Tumors ◽  
Skin Lesions ◽  
Melanocytic Nevus ◽  
Seborrheic Keratosis ◽  
Melanocytic Nevi ◽  
Medical College ◽  
Hematoxylin And Eosin ◽  
Pigmented Skin Lesions ◽  
Year 2013

Objectives: The purpose of this study is; firstly, to study the histopathologicalspectrum of the pigmented skin lesions in the community, to signify that not all pigmented skinlesions are malignant melanomas; secondly, to assess the age-wise distribution of the commonpigmented skin lesions; and thirdly, to determine the commonly affected body sites by thesepigmented skin lesions. Study Design: Retrospective/Observational study. Setting: CharsadaTeaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 100 consecutivecases with clinical diagnosis of pigmented skin lesion, starting in the year 2013. Methods: Inthis study, 100 consecutive surgical pathology cases with clinical diagnosis of pigmented skinlesion were retrieved from the archives of Charsada Teaching Hospital affiliated with JinnahMedical College Peshawar. All the specimens were incisional biopsies of skin, fixed in 10%formalin, embedded in paraffin, and stained with Hematoxylin and Eosin stains. Results: Onanalyzing 100 consecutive pigmented skin lesions (n=100) starting from the year 2013, it wasfound thatthe large majority of these lesions were benign. The most common pigmented skinlesion was melanocytic nevus. Moreover, majority of pigmented skin lesions were seen infemales. Seborrheic keratosis and malignant tumors, like basal cell carcinoma and squamouscell carcinomas, were more commonly seen in males in the 6th and 7th decades of life; whereas,dermatofibroma and post-inflammatory pigmentation were more common in females in the 4thand 5th decades of life. Overall, the pigmented skin lesions were more common in the 3rd, 4th, and5th decades of life with peak in the 4th decade. Skin of face was the most common site affectedby melanocytic nevi and malignant epidermal skin tumors. Conclusions: In conclusion, mostof the pigmented skin lesions are benign, encountered in the 4th decade of life, and commonlyaffect the skin of face. Also, most of the melanocytic nevi are encountered in females, whilemost of the malignant epidermal neoplasms are encountered in males affecting the skin of face.

Suppurative Infections in Hospitalized Patients – An Ongoing MRSA Threat

2020 ◽  
Author(s):  
Sadaf Razzak
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Science ◽  
Great Influence ◽  
Antibiotic Sensitivity ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance ◽  
Empiric Antibiotic ◽  
Medical Wards

Background: Penicillin resistance among Staphylococcus aureus commonly encountered in the hospital admitted patients. Detection of antibiotic sensitivity in hospital acquired methicillin resistant Staphylococcus aureus infections is important as it has great influence on empiric antibiotic prescription, successful control of infection, prevention of spread of disease and successful patient management. This study aimed to detect the frequency of HA-MRSA from pus samples in a hospital setup with assessment of their antibiotic susceptibility patterns. Method: A cross-sectional study was conducted in the Microbiology department of Basic Medical Science Institute, JPMC, Karachi from January 2015 until December 2015. Pus samples from surgical site wounds, skin lesions, abscesses from surgical and medical wards and ICUs were collected. According to the standards given by CLSI 2014, MRSA testing of the samples was done and susceptibility testing for antibiotics was performed. Inducible clindamycin resistance was detected by D-Test; E Test. determined MIC (minimum inhibitory concentration) for vancomycin. The data was analyzed by SPSS version 16. Result: Out of the 149 MRSA identified from the pus samples, 106 (71.14%) samples were HA-MRSA. The number of male patients was more than the female patients (67.66%). Out of the 106 HA-MRSA, 91(85.8%) were sensitive to TMP/SMX, 98(92.5%) to rifampicin, 12(11.6%) to gentamicin, 85(80.2%) to tetracycline, 11(10.4%) to erythromycin, 37(34.9%) to clindamycin, 20(18.9%) to ciprofloxacin, 106 (100%) to both vancomycin and linezolid. Conclusion: HA-MRSA showed sensitivity to TMP/SMX and vancomycin making them effective drugs to use in combination in superficial infections. The drug linezolid also showed 100% sensitivity.

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