A novel total body digital photography smartphone application designed to detect and monitor skin lesions: a pilot study

<p class="Body">Although some smartphone applications are designed for total body photography (TBP), few offer the specificity that enables self- as well as dermatologist-, detection of new lesions, or change in lesion color or in size as little as 1mm, on an ongoing basis. The aim of this study is to assess the sensitivity of a novel TBP application in the detection of changes to color and size of simulated skin lesions. Twenty-five subjects underwent one study visit. After baseline photography, new artificial markings were made or naturally occurring pigmented lesions located in any anatomical region were enhanced/enlarged, and a second matching set of photographs was then taken. From all 25 subjects, a total of 262 skin markings were evaluable. Of these, 241 (92%) were detected by the app, which resulted in an overall sensitivity of 92%. The high sensitivity establishes the app as capable of providing reliable self-TBP that allows detection and monitoring of new skin lesions or change in both size and color. This method greatly enhances the ability to accomplish ongoing self-monitoring and yet provides quality informing images to the dermatologist to assist in decision-making with the patient. </p>

Nevus of Ota associated with intracranial melanoma: Case report and review of the literature

<p>There is a known association between nevus of Ota and melanomas involving the brain parenchyma and/or the meninges. We present the unusual case of a 32-year-old African-American female with a nevus of Ota and a contralateral parenchymal, primary CNS melanoma. We discuss the unique features of this case and provide a brief review of the literature regarding nevi of Ota and associated CNS melanoma. Our patient is a 32 year-old, African-American female with a left-sided nevus of Ota who presented with a three month history of headaches and paresthesias involving her left face and arm. An MRI of the brain revealed a hemorrhagic mass in the right temporal lobe, which, after craniotomy, was determined to be a melanoma. Extensive imaging, ophthamologic examination and full-body skin examination revealed no other foci of melanoma. To our knowlege, this is the only case of a nevus of Ota associated with contralateral parenchymal melanoma in an African-American patient. The association of contralateral parenchymal primary CNS melanoma with nevus of Ota is extremely unusual. Futhermore, despite the association of nevus of Ota with CNS melanoma, the literature does not support routine screening of patients with nevus of Ota for CNS melanoma with imaging modalities. </p>

The diagnostic accuracy of the mobile phone teledermatoscopy

The positive predictive value (PPV) of smart mobile phone teledermatoscopy is not known. The main purpose of the present study was to investigate the sensitivity and positive predictive values (PPVs) of smart mobile phone teledermatoscopy. Over a period of 6 months, up to three clinical and dermatoscopic images were obtained of 67 skin lesions from 67 patients using a mobile phone camera and standard pocket dermatoscopy device. Out of the 67 patients, 44 were men (65.67%) and 23 were women (34.32%). The mean age of the patients was 39.56 ± 22.19 years (ranging from 18 to 92). The majority of the lesions (71.64%; n=48) were benign, while 11.94% (n=8) of the biopsies were premalignant and 16.41% (n=11) of the lesions were malignant. The sensitivity for the diagnosis of benign, premalignant, and malignant lesions were 93.8%, 100%, and 100%, respectively. PPVs for the diagnosis of benign, premalignant, and malignant lesions were 93.8%, 100%, and 100%, respectively. The sensitivity and PPVs of all lesions were 95.9% and 95.7%. The accuracy of the teledermatoscopic consultation with a mobile phone is very high. We therefore think that it can be a cost effective and useful method in the consultation at distance.

A randomized, double-blind, comparative study for efficacy assessment of two hyaluronic acid nasolabial fillers

<p class="Default">Hyaluronic acid fillers are considered safe for use in cosmetics as described in the safety assessment. This study was aimed to assess and compare the efficacy and safety of two hyaluronic acid (HA) fillers on mild nasolabial folds. Ten women aged 30-50 years with mild nasolabial folds participated for injection of A and B gels into right or left nasolabial folds. The volume and surface of nasolabial folds were measured by CSI software and the density and thickness of dermis assessed by skin ultrasonography before and 2, 12, and 24 weeks after injection. The data were analyzed using SPSS software version 20, and p-value &lt;0.05 were considered as significant. Global assessment showed over 50% improvement in patients injected with both gel A and B. At 2 weeks after injecting gel A the volume and surface of wrinkles decreased significantly. In the side injected with gel B, this reduction was significant at 2 and 12 weeks after injection. In addition, 24 weeks after injection of both gels the dermis echo-density increased and the dermis thickness decreased. This study indicated the significant positive filling effect of both HA fillers in decreasing the clinical signs of wrinkles at nasolabial folds. Comparing both fillers, there were not any statistically significant differences in any of measurements, but the persistence of gel B to improve the wrinkle appearance was slightly better than gel A. </p>

Volumetric estimation of autologous fat for augmentation of contour defects of face

<p>Autologous fat transfer for correcting contour defects of face has gained wide popularity in aesthetic surgery. However, quantification of fat requirement and its survival is still a fertile area for research to improve the predictability of volume retention of injected fat. There have been no detailed studies of the calculation for the amount of fat to be injected and percentage of fat retained. The objective of this study was to quantify the amount of fat required for correcting a facial deformity and amount retained postoperatively over a period of 6 months. Thirty patients were recruited in a prospective study where in, the fat requirement for augmenting the soft tissue defect was assessed using USG preoperatively and followed up at 1, 3 and 6 months by the same technique. It was found that USG is a simple, objective, reliable, cost-effective method of assessing the fat requirement and retention in autologous fat transfer.</p>

Fiddler’s neck: Cultural influences modify clinical presentation influences

<p>Fiddler’s neck which is also referred to as a “violin hickey” is a benign dermatologic occupational disease associated with the use of certain instruments like the violin, viola, cello etc. It is believed to be a type of allergic contact dermatitis, manifesting as an acute or chronic eczematous lesion typically at the submandibular and/or supraclavicular region on the side of neck. It can present as erythema, oedema and/or vesicles in the acute stage and as scaling, lichenification, hyperpigmentation and scarring in the chronic stage. Acne mechanica has also been considered by some authors as a presentation of fiddler’s neck. Occasionally, there may be associated swelling redness or a cystic lesion that makes it difficult to differentiate from lymphedema or a salivary gland tumor. PubMed search for articles about this entity resulting in instrument-induced dermatitis yielded few results of this forgotten entity which mimics a love bite (love hickey). For diagnosis, history of the usage of a string instrument which is held between the shoulder and neck, local physical examination and a positive patch test are pre-requisites. Management of fiddler’s neck includes application of topical mild steroid, emollient, proper instrument handling, neck padding, changing the material and polish of the instrument, and/or reducing the amount of playing time. Surgical intervention is usually not advisable unless cystic or tumorous lesions are the manifesting feature. The authors intend to revisit this entity and report an improvised modality that is being used by these instrumentalists in India which may help in prevention of this condition.</p>

A case with a giant trichilemmal cyst

<p>Trichilemmal cyst also known as pilar cyst first reported by Pinkus in 1969 t is the most common cyst in the parietal and occipital regions of the scalp. Herein we reported a case presented with a giant trichilemmal cyst and review the literature regarding differential diagnosis of this lesion.</p>

Giant Plexiform Neurofibroma

We report a rare case of giant plexiform neurofibroma in a patient affected by type-1 neurofibromatosis and we describe the correct surgical management of such lesions in order to avoid intra- and post-op blood loss related complications.

Cutaneous immune system: Age specificities

<p>The review is dedicated to the modern concepts in understanding the age-related changes of skin protective functions, with an emphasis on the impairments in interaction between the immune cells of innate and acquired immunity, resulting in a decrease in antigen-specific T cell immune surveillance in the skin. We discuss the various defects of T cells and their environment as well as focus on the issue of possible correction of T-reg and other cells activity in the skin which would increase the level of immune surveillance in elderly persons and reduce the risk of malignant neoplasms or skin infections developing.</p>