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2.
J Am Acad Dermatol ; 88(1): 144-151, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34793927

RESUMO

Basal cell carcinoma is the most common cancer worldwide, necessitating the development of techniques to decrease treatment costs through efficiency and efficacy. Mohs micrographic surgery, a specialized surgical technique involving staged resection of the tumor with complete histologic evaluation of the peripheral margins, is highly utilized. Reducing stages by even 5% to 10% would result in significant improvement in care and economic benefits. Noninvasive imaging could aid in both establishing the diagnosis of suspicious skin lesions and streamlining the surgical management of skin cancers by improving presurgical estimates of tumor sizes. Herein, we review the current state of imaging techniques in dermatology and their applications for diagnosis and tumor margin assessment of basal cell carcinoma prior to Mohs micrographic surgery.


Assuntos
Carcinoma Basocelular , Dermatopatias , Neoplasias Cutâneas , Humanos , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/cirurgia , Cirurgia de Mohs/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Dermatopatias/cirurgia , Diagnóstico por Imagem/métodos
3.
Photodermatol Photoimmunol Photomed ; 38(2): 95-98, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34467568

RESUMO

One early problem during the height of the COVID-19 global pandemic, caused by severe acute respiratory syndrome 2 (SARS-CoV-2), was the shortage of personal protective equipment donned by healthcare workers, particularly N95 respirators. Given the known virucidal, bactericidal, and fungicidal properties of ultraviolet irradiation, in particular ultraviolet C (UVC) radiation, our photomedicine and photobiology unit explored the role of ultraviolet germicidal irradiation (UVGI) using UVC in effectively decontaminating N95 respirators. The review highlights the important role of photobiology and photomedicine in this pandemic. Namely, the goals of this review were to highlight: UVGI as a method of respirator disinfection-specifically against SARS-CoV-2, adverse reactions to UVC and precautions to protect against exposure, other methods of decontamination of respirators, and the importance of respirator fit testing.


Assuntos
COVID-19 , Pandemias , COVID-19/prevenção & controle , Descontaminação , Reutilização de Equipamento , Saúde Global , Humanos , Respiradores N95 , Pandemias/prevenção & controle , SARS-CoV-2 , Raios Ultravioleta/efeitos adversos
4.
Photochem Photobiol ; 96(1): 208-214, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31464341

RESUMO

Human skin is exposed to visible light (VL; 400-700 nm) and long-wavelength ultraviolet A1 (UVA1) radiation (370-400 nm) after the application of organic broad-spectrum sunscreens. The biologic effects of these wavelengths have been demonstrated; however, a dose-response has not been investigated. Ten subjects with Fitzpatrick skin phototype IV-VI were enrolled. Subjects were irradiated with 2 light sources (80-480 J cm-2 ): one comprising VL with less than 0.5% UVA1 (VL+UVA1) and the other pure VL. Skin responses were evaluated for 2 weeks using clinical and spectroscopic assessments. 4-mm punch biopsies were obtained from nonirradiated skin and sites irradiated with 480 J cm-2 of VL+UVA1 and pure VL 24 h after irradiation. Clinical and spectroscopic assessments demonstrated a robust response at VL+UVA1 sites compared with pure VL. Histology findings demonstrated a statistically significant increase in the marker of inflammation (P < 0.05) and proliferation (P < 0.05) at the irradiated sites compared with nonirradiated control. Threshold doses of VL+UVA1 resulting in biologic responses were calculated. Results indicate that approximately 2 h of sun exposure, which equates to VL+UVA1 dose (~400 J cm-2 ), is capable of inducing inflammation, immediate erythema and delayed tanning. These findings reinforce the need of photoprotection beyond the UV range.


Assuntos
Luz , Pele/efeitos da radiação , Protetores Solares , Raios Ultravioleta , Adulto , Relação Dose-Resposta à Radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Espectral/métodos
5.
J Am Acad Dermatol ; 77(4): 591-605, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28917451

RESUMO

Postinflammatory hyperpigmentation (PIH) commonly occurs after various endogenous and exogenous stimuli, especially in dark-skinned individuals. PIH is one of the most common complications of procedures performed using laser and other light sources. The severity of PIH is determined by the inherent skin color, degree and depth of inflammation, degree of dermoepidermal junction disruption, inflammatory conditions, and the stability of melanocytes, leading to epidermal and dermal melanin pigment deposition. The depth of melanin pigment is the key factor to predict prognosis and treatment outcome. Epidermal hyperpigmentation fades more rapidly than dermal hyperpigmentation. Various inflammatory disorders can eventually result in PIH. The evaluation of pigmentation using noninvasive tools helps define the level of pigmentation in the skin, pigmentation intensity, and guides therapeutic approaches. This first article in this 2-part series discusses the epidemiology, pathogenesis, etiology, clinical presentation, differential diagnoses, and investigation using noninvasive assessment techniques that objectively determine the details of pigmentation.


Assuntos
Dermatite/complicações , Hiperpigmentação/diagnóstico por imagem , Hiperpigmentação/etiologia , Colorimetria , Diagnóstico Diferencial , Humanos , Hiperpigmentação/epidemiologia , Hiperpigmentação/patologia , Microscopia Confocal , Imagem Óptica , Fotografação/métodos , Índice de Gravidade de Doença , Fenômenos Fisiológicos da Pele , Análise Espectral/métodos
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