Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 351
Filtrar
1.
BMJ Case Rep ; 14(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33858891

RESUMO

Super giant basal cell carcinoma (BCC) is a rare oncological entity. A 52-year-old man with a history of a left upper facial lesion for 11 years was transferred to our facility seeking an evaluation. He frequented multiple hospitals where he was treated with antibiotics for this condition. He reported having the Mohs procedure 8 months prior to this hospital visit but he did not follow-up with the other institution. The physical examination revealed an ulcer involving the upper left orbito-fronto-parieto-temporal area with bone exposure. Both CT and MRI of the face and the brain demonstrated dehiscence of the left lateral orbital roof and left frontal bone. The biopsy confirmed advanced BCC. He was discharged against medical advice and lost to follow-up. He returned 1 month later with left eye discharge and vision loss. He was diagnosed with cerebral abscess, treated with antibiotics and discharged to hospice.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Gigantes , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/tratamento farmacológico , Carcinoma Basocelular/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Órbita , Neoplasias Cutâneas/tratamento farmacológico , Transtornos da Visão
3.
J Eur Acad Dermatol Venereol ; 35(5): 1099-1110, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33398911

RESUMO

BACKGROUND: Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT. OBJECTIVES: To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes. METHODS: Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes. RESULTS: Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules. CONCLUSIONS: This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Humanos , Microscopia Confocal , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagem , Tomografia de Coerência Óptica
4.
J Dermatol ; 48(5): 661-666, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33404107

RESUMO

The present, retrospective, single-center study analyzed various factors associated with primary basal cell carcinoma (BCC) in the period before and after the introduction of dermoscopy (BD and AD, respectively). The demographic data of patients with primary BCC between 2001 and 2005 (BD: 84 patients, 90 cases) and 2011 and 2018 (AD: 297 patients, 320 cases) were analyzed. In the pigmented BCC-predominant cohort (94%), the proportion of smaller tumors as well as the total number of tumors significantly increased during AD (median tumor size, 10.0 mm in BD, 8.0 mm in AD; Mann-Whitney U-test, p = 0.011). BCC were excised with a significantly narrower margin during AD (median, 2.0 mm) than during BD (median, 3.0 mm; Mann-Whitney U-test, p < 0.001; odds ratio, 0.30; multivariate logistic regression analysis, p < 0.001); the incomplete excision rate was 1.9%, and the recurrence rate was 0%. The present study suggests that the introduction of dermoscopy might have aided in the early diagnosis of smaller BCC, especially in the face region, and determining the appropriate surgical margin. The smaller pigmented BCC can be excised with a narrower margin than stated in the guidelines (4 mm).


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/cirurgia , Humanos , Margens de Excisão , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
5.
Vestn Oftalmol ; 136(6): 32-41, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084277

RESUMO

Tumor borders are one of the most significant characteristics of any tumor, including that of the skin. PURPOSE: To compare histological borders of periorbital skin tumors with their autofluorescence borders built from the analysis of non-induced protoporphyrin IX autofluorescence. MATERIAL AND METHODS: The study group included 8 patients with skin tumors of the eyelids, periorbital region, eyebrow and zygomatic regions aged 54-88 years. The tumors varied in size from 2 to 8 mm and all displayed signs of basal cell carcinoma (BCC). At admission, all the patients underwent non-induced autofluorescence diagnosis. The images were processed with the «CancerPlot¼ program. During radio excision, the autofluorescent border of each neoplasm was marked with a surgical incision of about 5 mm long and 2 mm deep. RESULTS: Upon pathomorphological examination, solid BCC was identified in 7 cases. The remaining case was senile keratosis. All reference incisions were located in healthy tissues not farther than 1 mm from the tumor (or keratosis locus, correspondingly). CONCLUSION: By the example of facial BCC, an evident correlation was established between histological borders of the tumor and its native (non-induced) protoporphyrin IX autofluorescence.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/diagnóstico por imagem , Pálpebras , Humanos , Pessoa de Meia-Idade , Pele , Neoplasias Cutâneas/diagnóstico por imagem
7.
J Dtsch Dermatol Ges ; 18(7): 682-690, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32657017

RESUMO

BACKGROUND: The melanin fluorescence of skin lesions is measurable with two-photon excitation, a process termed dermatofluoroscopy, which has shown a shift from the green spectra in benign melanocytic lesions to the red spectra in melanoma. This study addressed the question as to which kind of pigmented lesions can be correctly diagnosed as melanin-bearing malignant tumors. METHODS: 476 pigmented lesions including 101 cutaneous melanomas were analyzed with dermatofluoroscopy, measuring the melanin fluorescence in a grid-like fashion with a separation of measurement points of 0.2 mm. The results of the dermatofluoroscopy are presented as a diagnostic score with a cut-off score of ≥ 28 for the diagnosis of melanin-bearing malignant tumors, and were compared to the gold standard of histopathology. RESULTS: A highly significant difference (p < 0.0001) between the diagnostic scores of different skin tumors was found. Dermatofluoroscopy scores showed the highest sensitivity for melanomas (92.1 %). Interestingly, most pigmented basal cell carcinomas (BCCs, 88.9 %) were diagnosed as melanin-bearing malignant tumors. A higher sensitivity for the correct diagnosis was observed in older patients (≥ 53 years, p = 0.003), in patients with skin tanning (p = 0.025), and in patients with freckles during childhood (p = 0.046). CONCLUSIONS: Two-photon fluorescence is an innovative technique for the diagnosis of pigmented skin lesions, and shows a high sensitivity for detection of melanomas and pigmented BCCs.


Assuntos
Carcinoma Basocelular/diagnóstico por imagem , Dermoscopia , Fluoroscopia , Melanoma/diagnóstico por imagem , Nevo Pigmentado/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Diagnóstico Diferencial , Fluorescência , Humanos , Melanócitos , Microscopia de Fluorescência por Excitação Multifotônica , Sensibilidade e Especificidade , Pele/patologia
8.
Acta Chir Plast ; 61(1-4): 24-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32380839

RESUMO

Basal cell carcinoma (BCC) is the most prevalent malignancy, with rising incidence worldwide. Despite its naturally slow growth and initially low metastatic potential, it can cause significant morbidity and mortality when unrecognized, inadequately treated or poorly followed up. Authors present the case of a 61-year-old male with a 7-year history of multiple incomplete excisions of a “simple” BCC on the forehead. A CT scan of the head revealed an invasive mass (5.2 cm laterolateral x 4.0 cm craniocaudal) in the frontal area. There was no evidence of metastasis. Complete resection of the lesion and reconstruction was achieved in three stages. Final reconstruction was achieved using a left frontal fasciocutaneous flap. The secondary defect was closed with an advancement flap of the scalp and donor sites were covered using a split-thickness skin graft from the upper limb. This case demonstrates the necessity for vigilance in the approach to, diagnosis, treatment and follow-up of these skin neoplasms. The development of giant BCCs should be avoided at all costs. Increased size of BCCs corresponds with increased recurrence rate, metastatic rate, morbidity, mortality, treatment difficulties and overall costs.


Assuntos
Carcinoma Basocelular/prevenção & controle , Neoplasias Faciais/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/cirurgia , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Faciais/cirurgia , Testa , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos , Tomografia Computadorizada por Raios X
9.
An Bras Dermatol ; 95(3): 379-382, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32276794

RESUMO

In situations in when a dermoscopic record of a large lesion is desirable, the resulting images are usually restricted to a small field of view due to the limited diameter of dermatoscope lenses. This limitation often produces several photographs separately, thus losing the possibility of a single-image global evaluation. In these case reports, we show examples of a recently published image montage technique called Wide Area Digital Dermoscopy, in this case, applied to basal cell carcinomas.


Assuntos
Carcinoma Basocelular/diagnóstico por imagem , Dermoscopia/métodos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Carcinoma Basocelular/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Neoplasias Cutâneas/patologia , Software
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(3): 236-242, abr. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-191526

RESUMO

La microscopia confocal ex vivo es un sistema de procesamiento de tejidos que permite el análisis histológico inmediato de tejidos extirpados por medio de láseres diodo con distintos espectros de longitud de onda. En estudios previos la microscopia confocal ex vivo reduce el tiempo de análisis de márgenes de forma muy notable, con una sensibilidad y especificidad respecto a la histopatología del 88% y 99%, respectivamente. Recientemente se ha desarrollado una nueva tecnología que es capaz de proveer imágenes digitales con mayor velocidad y mejor resolución que las obtenidas en los dispositivos previos. Mediante el método de fusión (láseres de fluorescencia y reflectancia que escanean simultáneamente), se reproduce con una tinción digital la hematoxilina y eosina de forma inmediata en cada imagen. La implementación de esta nueva tecnología ha abierto definitivamente una puerta en el diagnóstico inmediato de tejidos


The ex vivo confocal microscope is an imaging system designed to analyze freshly excised tissue using two diode lasers with different wavelengths. The technique can dramatically reduce margin analysis times and offers a sensitivity of 88% and a specificity of 89% relative to histopathology. A new technology has recently been developed that produces images more quickly and with a higher resolution than before. By means of a fusion mode that combines simultaneously scanned fluorescence and reflectance images, it produces digitally stained images that simulate the effect of hematoxylin-eosin staining. Application of this new technology has opened the door to real-time tissue diagnostics


Assuntos
Humanos , Microscopia Confocal/métodos , Pele/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/instrumentação , Microscopia Confocal/instrumentação , Fluorescência , Biópsia , Interpretação de Imagem Assistida por Computador/instrumentação , Carcinoma Basocelular/diagnóstico por imagem
11.
Cient. dent. (Ed. impr.) ; 17(1): 49-55, ene.-abr. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-189749

RESUMO

El síndrome de Gorlin-Goltz (SGG) es también conocido como síndrome névico basocelular o síndrome del carcinoma nevoide basocelular. Fue mencionado por primera vez en 1894 por los doctores Jarish y White y fue descrito en 1960 por Robert J. Gorlin. Es un raro trastorno autosómico dominante, ocasionado por una mutación sufrida en el gen Patched 1 (PTCH1) ubicado en el cromosoma 9q223 (este gen desempeña un papel en la supresión tumoral, la estructuración embrionaria y el ciclo celular), que se caracteriza por defectos en el desarrollo y por elevar de manera significativa la predisposición a padecer algún tipo de cáncer. Su prevalencia es variable según el país, pero está aceptada una media de 1:60.000 habitantes/año, siendo la relación hombre/mujer de 1: 0,621. El diagnóstico del SGG puede resultar complejo debido a la variabilidad en la expresividad del síndrome y en la edad de presentación. La manifestación más común en la cavidad oral son los queratoquistes, lesiones que aparecen hasta en el 90% de los pacientes


Gorlin-Goltz Syndrome (GGS) is also known as basal cell nevus syndrome or nevoid basal cell carcinoma syndrome. It was first mentioned in 1894 by Doctors Jarish and White and described in 1960 by Robert J. Gorlin. It is a rare autosomal dominant condition, caused by a mutation suffered in the PTCH1 gene (Patched 1) located on chromosome 9q223 (this gene plays a role in tumour suppression, embryonic structuring and the cell cycle). It is characterised by defects in development and a significantly increased predisposition to suffering from some type of cancer. Its prevalence varies according to the country, but an average of 1 per 60,000 population/year is accepted, with the male/female ratio being 1:0.621. Diagnosing GGS can be complex due to the variability in the expressiveness of the syndrome and the age of presentation. The most common manifestation is the appearance of keratocysts in the oral cavity, which appear in up to 90% of patients


Assuntos
Humanos , Feminino , Criança , Síndrome do Nevo Basocelular/diagnóstico por imagem , Síndrome do Nevo Basocelular/cirurgia , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/complicações , Carcinoma Basocelular/cirurgia , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/patologia , Radiografia Panorâmica , Regeneração Óssea
12.
Korean J Radiol ; 21(3): 325-331, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32090525

RESUMO

OBJECTIVE: This study aimed to evaluate the efficacy of magnetic resonance (MR) imaging in differentiating between cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) in the head and neck region. MATERIALS AND METHODS: Among patients with cutaneous head and neck cancers, 14 with primary cBCCs and 15 with primary cSCCs with a histologic tumor height of ≥ 4 mm underwent MR examinations; the findings were then examined for correlations. RESULTS: cBCCs (71%) occurred more frequently on the nose than cSCCs (13%) (p < 0.01). The maximum diameter (23.5 ± 7.2 mm vs. 12.7 ± 4.5 mm; p < 0.01) and diameter-to-height ratio (2.8 ± 0.9 vs. 1.7 ± 0.4; p < 0.01) were significantly greater in cSCCs than in cBCCs. Superficial ulcer formation (67% vs. 21%; p < 0.05), protrusion into the subcutaneous tissue (60% vs. 21%; p < 0.05), ill-demarcated deep tumor margins (60% vs. 7%; p < 0.01), and peritumoral fat stranding (93% vs. 7%; p < 0.01) were more frequently observed in cSCCs than in cBCCs. Intratumoral T2-hyperintense foci (57% vs. 13%; p < 0.05) were more frequently observed in cBCCs than in cSCCs. CONCLUSION: cBCCs predominantly occurred on the nose with intratumoral T2-hyperintense foci, whereas cSCCs predominantly exhibited a flattened configuration, superficial ulcer formation, protrusion into the subcutaneous tissue, ill-demarcated deep tumor margin, and peritumoral fat stranding.


Assuntos
Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem
13.
Adv Anat Pathol ; 27(2): 98-111, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31895095

RESUMO

Basal cell carcinoma (BCC) of the skin is the most common type of malignant human tumor. However, metastatic BCC is a very rare event with weakly effective therapeutic options and a poor prognosis, until a few years ago. In 2012, small-molecule therapies, capable of inactivating the hedgehog signaling pathway and thus reducing tumor growth and progression, were introduced into clinical practice for the treatment of patients with advanced BCC. We present retrospectively 2 personal cases of metastatic BCC of the skin, from the premolecular therapy era, from primary tumors that arose years before in the head and neck area. The former case occurred in a 45-year-old woman with a history of recurrent BCC of the retroauricular skin who eventually died due to diffuse metastatic spread. The latter case concerned a 70-year-old man also with a history of recurrent BCC of the nasal-perinasal skin who developed multiple subcutaneous and lymph node metastases in the neck. In both cases, the diagnoses were based on biopsies of the metastatic sites. The first patient died 5 months after the diagnosis of metastatic disease, while the second was alive and disease-free 2 years after neck lymph node dissection and external radiation therapy, and then lost to follow-up. We extensively discuss several tumor entities with basal or basaloid features that may enter the differential diagnosis with BCC in metastatic sites. In addition, we briefly summarize the advances in clinical therapeutics using small molecules, which are now an integral part of the treatment of such advanced BCC cases.


Assuntos
Carcinoma Basocelular/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Adulto , Idoso , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/tratamento farmacológico , Carcinoma Basocelular/metabolismo , Diagnóstico Diferencial , Feminino , Proteínas Hedgehog/antagonistas & inibidores , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Recidiva Local de Neoplasia/patologia , Cintilografia , Estudos Retrospectivos , Bibliotecas de Moléculas Pequenas/uso terapêutico
14.
Lasers Med Sci ; 35(5): 1141-1151, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31853808

RESUMO

The differences in the biochemistry of normal and cancerous tissue could be better exploited by Raman spectroscopy when the spectral information from normal tissue is subtracted from the abnormal tissues. In this study, we evaluated the use of the normal-subtracted spectra to evidence the biochemical differences in the pre-cancerous and cancerous skin tissues compared with normal skin, and to discriminate the groups with altered tissues with respect to the normal sites. Raman spectra from skin tissues [normal (Normal), benign (dermatitis-BEN), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (KER)] were obtained in vivo (Silveira et al., 2015, doi: https://doi.org/10.1002/lsm.22318) and used to develop the spectral model. The mean spectrum of the normal sites (circumjacent to each lesion) from each subject was calculated and subtracted from each individual spectrum of that particular subject independently of the group (Normal, BEN, BCC, SCC, KERAT). The mean spectra of each altered group and the mean spectra of the differences were firstly evaluated in terms of biochemical contribution or differentiation comparing the normal site. Then, the normal-subtracted spectra were submitted to discriminant models based on partial least squares and principal components regression (PLS-DA and PCR-DA), and the discrimination were compared with the model using non-subtracted spectra. Results showed that the peaks of nucleic acids, lipids (triolein) and proteins (elastin and collagens I, III, and IV) were significantly different in the lesions, higher for the pre- and neoplastic lesions compared with normal and benign. The PLS-DA showed that the groups could be discriminated with 90.3% accuracy when the mean-subtracted spectra were used, contrasting with 75.1% accuracy when the non-subtracted spectra were used. Also, when discriminating non-neoplastic tissue (Normal + BEN) from pre- and neoplastic sites (BCC + SCC + KERAT), the accuracy increases to 92.5% for the normal-subtracted compared with 85.3% for the non-subtracted. The subtraction of the mean normal spectrum from the subject obtained circumjacent to each lesion could significantly increase the diagnostic capability of the Raman-based discrimination algorithm.


Assuntos
Algoritmos , Ceratose Actínica/diagnóstico , Neoplasias Cutâneas/diagnóstico , Pele/diagnóstico por imagem , Pele/patologia , Análise Espectral Raman , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/diagnóstico por imagem , Análise Discriminante , Humanos , Análise dos Mínimos Quadrados , Análise de Componente Principal
15.
J Craniofac Surg ; 31(1): e92-e95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31592843

RESUMO

INTRODUCTION: An increasing number of skin cancer arising over vascular anomaly has been reported in literature. In such cases, the oncologic radicality required to threat skin malignancies may be in contrast with the safety needed when dealing with vascular malformation. As a result, treatment of this association may be insidious and treacherous and imposes a sound knowledge and carefulness. MATERIALS AND METHODS: The authors report on a case of a 77-years-old woman affected by a basal cell carcinoma (BCC) arising over a vascular malformation of forehead. Preoperative radiological imaging revealed an underlying venous malformation (VM) communicating with intracranial district. Patient underwent sclerotherapy of the VM with gelified ethanol in order to reduce potentially fatal bleeding during surgery and, on the other hand, any leakage of the sclerosant in the intracranial veins. Excision of the BCC was then performed without complications. RESULTS: Neither intra-operative nor post-operative complications were observed. Current 3-years follow-up shows no recurrence of BCC whilst the residual VM is stable and clinically silent. CONCLUSIONS: Mechanisms leading to the onset of skin cancers over venous malformations are still unclear. However, association between these 2 conditions may be underestimated with possible catastrophic consequences. Thorough knowledge of vascular malformations and a multidisciplinary approach is of the uttermost importance when dealing with such clinical challenges.


Assuntos
Carcinoma Basocelular/cirurgia , Testa/cirurgia , Neoplasias Cutâneas/cirurgia , Malformações Vasculares/cirurgia , Veias/cirurgia , Idoso , Carcinoma Basocelular/irrigação sanguínea , Carcinoma Basocelular/diagnóstico por imagem , Feminino , Testa/irrigação sanguínea , Testa/diagnóstico por imagem , Humanos , Procedimentos Cirúrgicos Reconstrutivos , Soluções Esclerosantes/uso terapêutico , Escleroterapia , Neoplasias Cutâneas/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/tratamento farmacológico , Veias/diagnóstico por imagem
18.
Sci Rep ; 9(1): 18670, 2019 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-31822752

RESUMO

Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.


Assuntos
Angiografia , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/tratamento farmacológico , Fotoquimioterapia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/tratamento farmacológico , Tomografia de Coerência Óptica , Idoso , Idoso de 80 Anos ou mais , Ácido Aminolevulínico/administração & dosagem , Carcinoma Basocelular/irrigação sanguínea , Estudos de Coortes , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Fármacos Fotossensibilizantes/administração & dosagem , Pele/patologia , Neoplasias Cutâneas/irrigação sanguínea , Resultado do Tratamento
19.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(9): 1063-1070, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31645498

RESUMO

OBJECTIVE: To construct an intelligent assistant diagnosis model based on the clinical images of basal cell carcinoma (BCC) and pigmented nevi in Chinese by using the advanced convolutional neural network (CNN).
 Methods: Based on the Xiangya Medical Big Data Platform, we constructed a large-scale clinical image dataset of skin diseases according to Chinese ethnicity and the Xiangya Skin Disease Dataset. We evaluated the performance of 5 mainstream CNN models (ResNet50, InceptionV3, InceptionResNetV2, DenseNet121, and Xception) on a subset of BCC and pigmented nevi of this dataset. We also analyzed the basis of the diagnosis results in the form of heatmaps. We compared the optimal CNN classification model with 30 professional dermatologists.
 Results: The Xiangya Skin Disease Dataset contains 150 223 clinical images with lesion annotations, covering 543 skin diseases, and each image in the dataset contains support for pathological gold standards and the patient's overall medical history. On the test set of 349 BCC and 497 pigmented nevi, the optimal CNN model was Xception, and its classification accuracy can reach 93.5%, of which the area under curve (AUC) values were 0.974 and 0.969, respectively. The results of the heatmap showed that the CNN model can indeed learn the characteristics associated with disease identification. The ability of the Xception model to identify clinical images of BCC and Nevi was basically comparable to that of professional dermatologists.
 Conclusion: This study is the first assistant diagnosis study for skin tumor based on Chinese ethnic clinical dataset. It proves that CNN model has the ability to distinguish between Chinese ethnicity's BCC and Nevi, and lays a solid foundation for the following application of artificial intelligence in the diagnosis and treatment for skin tumors.


Assuntos
Carcinoma Basocelular/diagnóstico por imagem , Redes Neurais de Computação , Nevo Pigmentado/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Área Sob a Curva , Humanos
20.
Comput Methods Programs Biomed ; 178: 201-218, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31416550

RESUMO

BACKGROUND AND OBJECTIVE: Skin cancer is the commonest form of cancer in the worldwide population. Non-invasive and non-contact imaging modalities are being used for the screening of melanoma and other cutaneous malignancies to endorse early detection and prevention of the disease. Traditionally it has been a problem for medical personnel to differentiate melanoma, dysplastic nevi and basal cell carcinoma (BCC) diseases from one another due to the confusing appearance and similarity in the characteristics of the pigmented lesions. The paper reports an integrated method developed for identifying these skin diseases from the dermoscopic images. METHODS: The proposed integrated computer-aided method has been employed for the identification of each of these diseases using recursive feature elimination (RFE) based layered structured multiclass image classification technique. Prior to the classification, different quantitative features have been extracted by analyzing the shape, the border irregularity, the texture and the color of the skin lesions, using different image processing tools. Primarily, a combination of gray level co-occurrence matrix (GLCM) and a proposed fractal-based regional texture analysis (FRTA) algorithm has been used for the quantification of textural information. The performance of the framework has been evaluated using a layered structure classification model using support vector machine (SVM) classifier with radial basis function (RBF). RESULTS: The performance of the morphological skin lesion segmentation algorithm has been evaluated by estimating the pixel level sensitivity (Sen) of 0.9172, 0.9788 specificity (Spec), 0.9521 accuracy (ACU), along with the image similarity measuring indices as Jaccard similarity index (JSI) of 0.8562 and Dice similarity coefficient (DSC) of 0.9142 with respect to the corresponding ground truth (GT) images. The quantitative features extracted from the proposed feature extraction algorithms have been employed for the proposed multi-class skin disease identification. The proposed layered structure identifies all the three classes of skin diseases with a highly acceptable classification accuracy of 98.99%, 97.54% and 99.65% for melanoma, dysplastic nevi and BCC respectively. CONCLUSION: To overcome the difficulties of proper diagnosis of diseases based on visual evaluation, the proposed integrated system plays an important role by quantifying the effective features and identifying the diseases with higher degree of accuracy. This combined approach of quantitative and qualitative analysis not only increases the diagnostic accuracy, but also provides some important information not obtainable from qualitative assessment alone.


Assuntos
Carcinoma Basocelular/diagnóstico por imagem , Fractais , Processamento de Imagem Assistida por Computador/métodos , Melanoma/diagnóstico por imagem , Nevo/diagnóstico por imagem , Adulto , Algoritmos , Dermoscopia , Diagnóstico por Computador , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Automatizado de Padrão , Pigmentação , Reprodutibilidade dos Testes , Máquina de Vetores de Suporte
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...