Acta dermato-venereologica最新文献

A 50-year-old male presented with 4-month history of longitudinal melanonychia on the fourth digit of his right foot. A nail matrix and bed biopsy was performed, which led to the diagnosis of invasive well-differentiated squamous cell carcinoma. Immunohistochemical analysis demonstrated positivity for P16 and P40. Longitudinal melanonychia may be a diagnostic challenge, as it can be associated with both benign and malignant conditions. Given the potential for locally aggressive behaviour, squamous cell carcinoma should always be considered in cases of longitudinal melanonychia. A systematic review was conducted in order to analyse all documented cases of invasive squamous cell carcinomas that presented as longitudinal melanonychia, highlighting any associated clinical, dermoscopic, histological, and immunohistochemical characteristics potentially useful for an early identification of this neoplasm.

Hyperspectral imaging is a non-invasive imaging modality showing potential in delineating tumour margins preoperatively. This pilot study evaluated the feasibility of using hyperspectral imaging to demarcate lateral margins of high-risk facial basal cell carcinomas (BCC) prior to Mohs micrographic surgery. Thirty patients with high-risk BCCs were recruited from the Department of Dermatology, Sahlgrenska University Hospital, Sweden. Lesions were initially demarcated using dermoscopy, followed by hyperspectral imaging scans. During the first stage, a superficial vertical incision was performed along the demarcation line before adding a 3-mm clinical margin for the bowl-shaped excision of the tumour. Hyperspectral imaging-based tumour margins were compared with histopathologically verified borders, serving as ground truth. The data analysis used supervised learning; 2 complementary validation strategies were employed: a half-split approach where the left half of each annotated image was used for training and the right half for testing, and a leave-one-out cross-validation at the image level. A pixel-wise classification approach was used, treating each pixel as an independent sample. Hyperspectral imaging achieved a pixel-wise classification accuracy of 0.76, sensitivity of 0.75, specificity of 0.78, and an area under the receiver operating characteristic curve of 0.84. Hyperspectral imaging demonstrated potential for tumour demarcation, providing a basis for future research.

Delusional infestation is a rare but severe dermatopsychiatric disorder. The diagnosis is associated with great suffering for the patients and their relatives, as well as substantial use of healthcare resources. It has been observed that patients with delusional infestation often have psychiatric comorbid conditions. Neurodegenerative diseases like dementia have been reported to be associated, but only in a few case reports. An observational, retrospective search was conducted in the institutional database and all medical records of patients with a diagnostic ICD code in the range F40.0-F40.9 (i.e., phobic anxiety disorders) were collected. A total of 146 patients met the criteria of delusional infestation; 42% were observed to have a former or current psychiatric comorbidity. Half the group, 50%, had more than 1 concomitant psychiatric diagnosis; depressive and/or anxiety disorder was the most common (62%). Furthermore, 9.6% developed dementia during the investigation period. Psychiatric comorbid conditions are common in this patient group. Such conditions should be diagnosed and treated. Further, delusional infestation could be an early sign of dementia and if signs of cognitive impairment are noted, further investigations and follow-up regarding dementia are recommended.