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Dermatology ◽  
2022 ◽  
pp. 1-10
Author(s):  
Angelo Valerio Marzano ◽  
Giovanni Genovese ◽  
Chiara Moltrasio ◽  
Paola Maura Tricarico ◽  
Rossella Gratton ◽  
...  

<b><i>Background:</i></b> The genetics of syndromic hidradenitis suppurativa (HS), an immune-mediated condition associated with systemic comorbidities such as inflammatory bowel diseases and arthritis, has not been completely elucidated. <b><i>Objective:</i></b> To describe clinical features and genetic signature of patients with the main syndromic HS forms, i.e., PASH, PAPASH, and PASH/SAPHO overlapping. <b><i>Methods:</i></b> Whole-exome sequencing (WES) approach was performed in ten patients with syndromic HS. <b><i>Results:</i></b> Three clinical settings have been identified based on presence/absence of gut and joint inflammation. Four PASH patients who had also gut inflammation showed three different variants in <i>NOD2</i> gene, two variants in <i>OTULIN</i>, and a variant in <i>GJB2</i>, respectively. Three PAPASH and three PASH/SAPHO overlapping patients who had also joint inflammation showed two different variants in <i>NCSTN</i>, one in <i>WDR1</i> and <i>PSTPIP1</i>, and two variants in <i>NLRC4</i>, one of whom was present in a patient with a mixed phenotype characterized by gut and joint inflammation. <b><i>Limitations:</i></b> Limited number of patients that can be counterbalanced by the rarity of syndromic HS. <b><i>Conclusion:</i></b> Syndromic HS can be considered as a polygenic autoinflammatory condition; currently WES is a diagnostic tool allowing more accurate genotype-phenotype correlation.


Dermatology ◽  
2022 ◽  
pp. 1-19
Author(s):  
Alexandra Laverde-Saad ◽  
Alexe Simard ◽  
David Nassim ◽  
Abdulhadi Jfri ◽  
Ali Alajmi ◽  
...  

Advances in ultrasound technology and non-surgical treatments of basal cell carcinomas (BCCs) have raised the need to study the performance of high-frequency ultrasound (HFUS) in BCCs. We aimed to assess the performance of HFUS in the evaluation of BCCs to formulate recommendations for its uses and conducted a systematic review of the literature to do so. A search of Central, Medline, Embase, CINHAL, and Web of Science was performed using key/MESH terms “ultrasonography” and “basal cell carcinoma” (January 2005–December 2020). We included primary studies reporting biopsy-confirmed BCCs for which the target intervention was ultrasound assessment at 15 MHz or higher frequency. Thirty articles were included, studying a total of 1,203 biopsy-confirmed BCCs. HFUS provides accurate depth measurements, especially for BCCs &#x3e;1 mm. The definition of lateral margins in vivo needs further studies; however, ex vivo margin assessment seems convincing. There is a diagnostic role for HFUS in identifying higher recurrence risk BCC subtypes, which can help in risk stratification. Performance of HFUS is significant in BCC management. Pre-surgical scans may support case selection for Mohs. HFUS can improve safety when used to plan brachytherapy treatments, help with case selection and adjunct treatment choice pre-photodynamic therapy. Finally, HFUS can help follow lesions after intervention, particularly non-surgical management, and support the decision to observe or re-intervene. HFUS can enhance clinical practice by providing useful information that cannot be deducted from the clinical examination. It would be recommended to evaluate the extent, mainly depth, and detect the aggressiveness of the BCCs.


Dermatology ◽  
2022 ◽  
pp. 1-9
Author(s):  
Zainab Jiyad ◽  
Elsemieke I. Plasmeijer ◽  
Samantha Keegan ◽  
Venura Samarasinghe ◽  
Adele C. Green ◽  
...  

<b><i>Background:</i></b> Skin self-examination (SSE) is widely promoted for the detection of suspicious pigmented lesions. However, determining screening accuracy is essential to appraising the usefulness of SSE. <b><i>Objectives:</i></b> The aim of this work was to pool estimates from studies of SSE diagnostic accuracy in the detection of suspicious pigmented lesions. <b><i>Methods:</i></b> This study was registered with PROSPERO (CRD42021246356) and conducted in accordance with PRISMA-DTA guidelines. A systematic search of Medline (PubMed) EMBASE, CINAHL, and The Cochrane Library was conducted to identify relevant studies. We included studies that examined the accuracy of SSE, either whole-body or site-specific, for detecting change in individual pigmented lesions or detecting an atypical naevus. A univariate random-effects model, based on logit-transformed data, was used to calculate a summary diagnostic odds ratio (DOR) as well as pooled sensitivity and specificity. Cochran’s <i>Q</i> test and the <i>I</i><sup>2</sup> statistic were calculated to assess heterogeneity. A proportional hazards model was used to calculate the area under the curve (AUC) and plot the summary receiver operator characteristic curve. We used the Quality Assessment of Diagnostic Accuracy Studies-2 tool to grade study quality. <b><i>Results:</i></b> We identified 757 studies, of which 3 met inclusion criteria for quantitative synthesis. The pooled sensitivity and specificity based on 553 included participants was 59 and 82%, respectively. The summary DOR was 5.88 and the AUC was 0.71. There were some concerns regarding risk of bias in all 3 studies. <b><i>Conclusions:</i></b> SSE can detect suspicious pigmented lesions with reasonable sensitivity and relatively high specificity, with the AUC suggesting acceptable discriminatory ability.


Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Patrycja Rogowska ◽  
Michał Sobjanek ◽  
Martyna Sławińska ◽  
Roman J. Nowicki ◽  
Aneta Szczerkowska-Dobosz

<b><i>Background:</i></b> The frequency of tattoos varies from 10% to 30% across the population worldwide. The growing popularity of tattooing increases the number of cutaneous reactions connected with this procedure. As we have not found any previous studies in the literature concerning tattoo complications in Poland and other Eastern European countries, we believe this to be the first study of this kind. <b><i>Objective:</i></b> The primary objective of this study was to evaluate the clinical spectrum of complications associated with the procedure of permanent tattooing among patients from Northern Poland. <b><i>Methods:</i></b> Medical data of 53 patients who developed tattoo-related cutaneous conditions were analyzed. All of the patients were consulted in the Dermatology, Venereology and Allergology Clinic in Gdańsk in the years 2018–2021. Medical history, dermatological assessment, and photographic documentation of skin lesions were performed in each case. Dermoscopic examination was carried out in 16 cases and 20 skin biopsies of the tattoo reactions were performed. <b><i>Results:</i></b> Twenty-one patients (40%) presented tattoo ink hypersensitivity reactions, out of which 18 were triggered by the red ink. In 11 cases (21%), contact dermatitis has developed after tattooing, while 9 of the patients (17%) presented tattoo infectious complications, including local bacterial infections, common warts, molluscum contagiosum, and demodicosis. We collected 8 cases (15%) of papulonodular reactions in black tattoos, and in 6 of them, histology showed granuloma formation. In 2 cases (4%), symptoms of anaphylaxis were observed after the tattooing procedure, and in another 2 cases (4%), Koebner phenomenon in the tattoo was diagnosed. Dermoscopy was the clue to the diagnosis in 4 cases. <b><i>Conclusions:</i></b> This is the first report presenting multiple cases of tattoo complications from Eastern Europe. The results of the study are consistent with other researches, showing a similar distribution of tattoo complications and that across the different pigments used, the red ink is most frequently responsible for tattoo reactions. We emphasize the usefulness of dermoscopic examination in the diagnosis of tattoo-related infections and draw the reader’s attention to the rare, yet hazardous complications connected with peri-tattooing anaphylaxis.


Dermatology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Simon Bossart ◽  
Simone Cazzaniga ◽  
Torsten Willenberg ◽  
Albert-Adrien Ramelet ◽  
Kristine Heidemeyer ◽  
...  

<b><i>Background:</i></b> The skin hyperpigmentation index (SHI), a new objective method for measuring skin hyperpigmentation, needs validation. <b><i>Objective:</i></b> To gain evidence of the reliability and validity of the SHI. <b><i>Methods:</i></b> Fifteen raters were divided into 3 groups (5 dermatologists, 5 nondermatologist physicians, and 5 nonphysician clinicians). Each rated 5 pigmented mole lesions with mild-to-severe hyperpigmentation to determine intra- and interrater reliability. All raters photographed the lesions and rated them using the subjective Physician Global Assessment (PGA) score. The same photographs were then assessed based on automatic computer measurement software using the online SHI tool (https://shi.skinimageanalysis.com). <b><i>Results:</i></b> The SHI reliability was excellent for all intra- and interrater assessments, while most PGA assessments showed good intra- and interrater agreement. Between-group reliability was excellent for SHI, while moderate-to-good for PGA evaluations. Concordance between the SHI and PGA assessments was strong across all groups of assessors. <b><i>Conclusion:</i></b> There is evidence that the SHI is a reliable instrument for measuring skin hyperpigmentation, and can be used by nonexperienced clinicians.


Dermatology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Jawaher Tariq A. AlMulhem ◽  
Farah A.O.A. Zuaiter

Acneiform eruption is a devastating cutaneous side effect of cetuximab, a monoclonal antibody used to treat a variety of cancers. Despite its effectiveness, many patients avoid or discontinue it after experiencing its dermatological side effects as it negatively impacts their quality of life (QoL). This displays the immense need for multidisciplinary collaboration to prevent and treat cetuximab-induced acneiform eruption (CIAE). Prevention methods include, but are not limited to, education, skin care routines, and prophylactic drugs. The following measures reduce the likelihood of developing CIAE and decrease its severity, making it easier to treat if it were to occur. Ongoing research on the treatment of CIAE continues. Of these treatments, oral tetracyclines and systemic corticosteroids have been shown to be the most effective by far. This commentary aims to evaluate the study by Park et al. [Dermatology. 2021;237(3):457–63], further elaborate on prevention and treatment measures of CIAE, and highlight the implications of CIAE on a patient’s QoL.


Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
S. Morteza Seyed Jafari ◽  
Simone Cazzaniga ◽  
Simon Bossart ◽  
Laurence Feldmeyer ◽  
Lorenzo Pelloni ◽  
...  

<b><i>Background:</i></b> Actinic keratosis (AK) is the most common precancerous cutaneous lesion, with risk of progression to cutaneous squamous cell carcinoma. In the current study, we evaluated the efficacy of 20-MHz high-intensity focused ultrasound (HIFU), as a new treatment modality for AK. <b><i>Materials and Methods:</i></b> Patients with AK lesions (grades I–III) treated with HIFU were included in the study. The clinical assessment was performed 3 months after therapy. <b><i>Results:</i></b> Twenty-one patients (14 men, 7 women) with 108 AK lesions (grades I–III) were included in the current study. Ages ranged from 62 to 85 years (mean 72.6 years). Clinically complete resolution of the actinic damage in the treated area was detected in 72.2% of lesions. Furthermore, 28 lesions (26%) showed a reduction of the AK grade, or partial response, after the therapy. Most of the patients experienced annoying but short pain during the procedure. However, late adverse effects of the therapy, such as hypopigmentation, hyperpigmentation and erythema were reported only in a small portion of the lesions. <b><i>Conclusions:</i></b> 20-MHz HIFU could be an effective and safe alternative treatment for AK.


Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Suzanne Moloney ◽  
Barry M. McGrath ◽  
Davood Roshan ◽  
Georgina Gethin

<b><i>Background:</i></b> Recurring nodules, abscesses, and lesions characterise hidradenitis suppurativa (HS): a chronic, inflammatory skin disorder. Globally the prevalence of HS is estimated to be around 1% of the population. Leakage, pain, and odour from HS wounds require substantial management. Little is known of the personal burdens that routine wound management imposes on the patient. <b><i>Objectives:</i></b> To evaluate how routine HS wound management impacts patients in terms of the time spent changing dressings, the number of dressings required per day, pain experienced during dressing changes, and negative impact on various domains of their personal lives. <b><i>Methods:</i></b> An anonymous online questionnaire was posted on closed social media patient support groups between April and May 2019. Pearson χ<sup>2</sup> test was used to evaluate if Hurley stages influenced the personal impact of wound care routines on patients. Statistical significance was determined as <i>p</i> value &#x3c;0.05. <b><i>Results:</i></b> In total<i>,</i> 908 people from 28 countries responded. Of these, 81% (<i>n</i> = 734) reported that regular dressing changes negatively impacted on their quality of life. Most patients, 82% (<i>n</i> = 744), experience pain during dressing changes. 16% (<i>n</i> = 142) of patients required five or more dressings daily, and 12% (<i>n</i> = 108) spend over 30 min daily tending to wounds. Patients indicated high levels of dissatisfaction with currently available wound dressings. <b><i>Conclusion:</i></b> HS wound management imposes a substantial personal burden on patients. There is a clear unmet need for HS-specific wound dressings and wound care provisions, and a greater awareness of the condition and its impact is needed among clinicians.


Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Clarissa Prieto Herman Reinehr ◽  
Renato Marchiori Bakos

<b><i>Background:</i></b> The quantitative and qualitative presence of melanocytic nevi is considered a significant risk factor for melanoma. Little is known whether patients showing any of the recognized global dermoscopic nevus patterns might also be considered at increased risk for the disease. <b><i>Objectives:</i></b> We aimed to investigate the frequency of global dermoscopic patterns of common nevi among melanoma patients and compare them to controls, as well as the dermoscopic patterns of atypical nevi between the groups. <b><i>Methods:</i></b> We included consecutive melanoma patients and age- and sex-matched controls who presented to our Department with at least 10 melanocytic nevi. Total body examination was performed, and all nevi had their dermoscopic pattern described. Global dermoscopic patterns of nevi were compared between groups, as well as atypical nevus patterns. Finally, nevus patterns were stratified by their location and also compared between groups. <b><i>Results:</i></b> We included 120 melanoma patients and 120 controls. Melanoma patients presented a larger number of common (<i>p</i> = 0.002) and atypical melanocytic nevi (<i>p</i> &#x3c; 0.001) and more variability of dermoscopic nevus patterns (<i>p</i> &#x3c; 0.001). No difference in the global dermatoscopic pattern of common nevi was observed between groups. The complex pattern of atypical nevi was associated with melanoma (OR = 2.87). Melanoma patients also showed more common nevi with a reticular pattern on the back (<i>p</i> = 0.014) and lower limbs (<i>p</i> = 0.041) as well as atypical nevi on the back with reticular pattern (<i>p</i> = 0.01), with reticular-homogeneous pattern (<i>p</i> = 0.001), and with reticular-globular pattern (<i>p</i> = 0.048) than controls. Nevi with multifocal pigmentation were also more frequent among melanoma patients (OR = 2.61). <b><i>Conclusion:</i></b> Melanoma patients tend to present a higher number of common reticular nevi on the back and lower limbs, as well as atypical nevi with a complex pattern, especially reticular, reticular-homogeneous, and reticular-globular on the back.


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