JEADV clinical practice最新文献_第2页

Incidence and geographic differences in keratinocyte carcinoma and Bowen's disease in office-based dermatological practice between 2013 and 2022: A nationwide Danish registry-based study 2013 年至 2022 年诊所皮肤科角质细胞癌和鲍温氏病的发病率和地域差异：一项基于丹麦全国登记册的研究

JEADV clinical practice

Pub Date : 2024-06-13 DOI: 10.1002/jvc2.478

Johan Sieborg, Merete Haedersdal, Ulrikke Lei, Henrik Sølvsten, Anne Braae Olesen, Gabrielle Randskov Vinding, Anna Lei Lamberg, Alexander Egeberg, Emily Wenande

Background

Rates of keratinocyte carcinoma (KC) across Europe are impacted by population demographics and geography. Regional differences in KC occurrence exist, but few European studies investigate incidences of specific subtypes in the secondary healthcare sector on a national level.

Objectives

To determine geographical differences in incidence rate and lifetime risk of KC subtypes across Denmark, including nodular and superficial basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and the KC precursor, Bowen's disease (BD), identified in office-based dermatological practice.

Methods

Based on a nationwide registry (The Danish Skin Cancer Registry), all patients in Denmark's five regions with a histologically- or clinically verified KC or BD registered in a state-funded office-based dermatology practice between 2013 and 2022 were included. Trends in national- and region-specific age and sex standardised tumour incidence rates (STIR) were calculated. Further, national lifetime risk of each tumour subtype was estimated.

Results

Between 2013 and 2022, the combined STIR for KC/BD rose 172% nationally from 180 to 489 per 100,000 person-years (PY). This increase reflected rising rates of nodular BCC, SCC, and BD, while superficial BCC incidence was relatively stable. Regional differences in STIR for combined KC/BD were observed, with the Capital Region and North Jutland generally demonstrating higher rates than Zealand, Southern- and Central Denmark (e.g., North Jutland vs. Southern Denmark: 714 vs. 405/100,000PY). While the estimated lifetime risk of developing at least one KC or BD tumour was 21.8%, risk varied with tumour subtype, resulting in subtype-specific risks of 16.4%, 5.1%, 1.9% and 1.3% for nodular BCC, superficial BCC, SCC, and BD, respectively.

Conclusions

In Denmark's secondary dermatological care sector, incidence of nodular BCC, SCC and BD continues to rise with an overall lifetime risk nearing 22%. While KC incidence is increasing in Denmark, the study detected differences in geographical trends and rate increases of specific tumour subtypes.

欧洲的角质细胞癌（KC）发病率受到人口和地理因素的影响。为了确定丹麦各地KC亚型（包括结节性和浅表基底细胞癌（BCC）、鳞状细胞癌（SCC）和KC前体鲍温氏病（BD））的发病率和终生风险的地域差异，我们在诊室皮肤科实践中发现了这些亚型。丹麦皮肤癌登记处（The Danish Skin Cancer Registry）是一个全国性的登记机构，2013年至2022年期间，丹麦五个大区所有在国家资助的皮肤科诊室登记的、经组织学或临床证实患有KC或BD的患者均被纳入其中。计算了全国和地区特异性年龄和性别标准化肿瘤发病率（STIR）的变化趋势。此外，还估算了每种肿瘤亚型的全国终生风险。2013年至2022年间，KC/BD的全国综合STIR上升了172%，从每10万人年180例上升至489例。这一增长反映了结节性 BCC、SCC 和 BD 发病率的上升，而表皮 BCC 发病率则相对稳定。合并 KC/BD 的 STIR 存在地区差异，首都地区和北日德兰通常高于西兰岛、南丹麦和中丹麦（例如，北日德兰对南丹麦：714 对 405/100,000PY）。据估计，一生中至少罹患一种 KC 或 BD 肿瘤的风险为 21.8%，但风险随肿瘤亚型的不同而不同，结节性 BCC、表皮 BCC、SCC 和 BD 的亚型特异性风险分别为 16.4%、5.1%、1.9% 和 1.3%。在丹麦的二级皮肤病护理部门，结节性 BCC、SCC 和 BD 的发病率持续上升，一生中的总体风险接近 22%。虽然丹麦的 KC 发病率在不断上升，但该研究发现，特定肿瘤亚型的地域趋势和发病率增长存在差异。

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引用次数: 0

Quality of life in patients with anogenital warts: A cross‐sectional study using the Dermatology Life Quality Index questionnaire 生殖器疣患者的生活质量：使用皮肤科生活质量指数问卷进行的横断面研究

JEADV clinical practice

Pub Date : 2024-06-03 DOI: 10.1002/jvc2.480

GC Sagar, S. Paudel, Prajwal Pudasaini, Sadiksha Adhikari

引用次数: 0

A dermoscopy case series of cutaneous metastases from breast cancer in Filipino females 菲律宾女性乳腺癌皮肤转移的皮肤镜病例系列

JEADV clinical practice

Pub Date : 2024-06-03 DOI: 10.1002/jvc2.473

Rouslia Q. Alfaro, Arunee H. Siripunvarapon, Maria F. S. Quinio, Celine M. H. Duran, Joanne R. Pamin, Claire M. R. Habito

There is a limited number of dermoscopic images of cutaneous metastases from breast cancer. We report three cases of cutaneous metastases in Filipino females with breast cancer. They were referred to the Dermatology outpatient clinic with round, firm, nontender, erythematous nodules on the chest and trunk. Dermoscopic findings noted were linear, irregular, arborizing and polymorphic vessels, bright white lines at the periphery and white areas, homogenous yellow to yellow‐orange structureless areas with linear fissure‐like structures and irregular diffuse blue‐black pigmentation, multiple brown dots and globules, and pink homogeneous areas. The clinical presentation, dermoscopy, histopathology and immunohistochemistry findings were consistent with cutaneous metastases from breast cancer. Familiarity and knowledge of dermoscopic patterns will improve diagnostic accuracy and early recognition of cutaneous metastases.

有关乳腺癌皮肤转移的皮肤镜图像数量有限。我们报告了三例菲律宾女性乳腺癌皮肤转移病例。她们因胸部和躯干出现圆形、坚实、无触痛的红斑结节而被转诊至皮肤科门诊。皮肤镜检查结果为线状、不规则、树枝状和多形性血管，周边和白色区域有明亮的白线，同质的黄色至黄橙色无结构区域有线状裂隙样结构和不规则的弥漫性蓝黑色色素沉着，多个棕色小点和球状物，以及粉红色同质区域。临床表现、皮肤镜检查、组织病理学和免疫组化检查结果与乳腺癌皮肤转移一致。熟悉和了解皮肤镜模式将提高诊断的准确性，并能及早识别皮肤转移瘤。

引用次数: 0

Orf (contagious ecthyma) transmitted by a cat 由猫传播的 Orf（传染性软疣

JEADV clinical practice

Pub Date : 2024-06-03 DOI: 10.1002/jvc2.481

Victoire Laumondais, Muriel Delhomme, L. Misery

引用次数: 0

Usefulness of the large language model ChatGPT (GPT‐4) as a diagnostic tool and information source in dermatology 大型语言模型 ChatGPT（GPT-4）作为皮肤病学诊断工具和信息来源的实用性

JEADV clinical practice

Pub Date : 2024-06-03 DOI: 10.1002/jvc2.459

Jacob P. S. Nielsen, Christian Grønhøj, L. Skov, M. Gyldenløve

The field of artificial intelligence is rapidly evolving. As an easily accessible platform with vast user engagement, the Chat Generative Pre‐Trained Transformer (ChatGPT) holds great promise in medicine, with the latest version, GPT‐4, capable of analyzing clinical images.To evaluate ChatGPT as a diagnostic tool and information source in clinical dermatology.A total of 15 clinical images were selected from the Danish web atlas, Danderm, depicting various common and rare skin conditions. The images were uploaded to ChatGPT version GPT‐4, which was prompted with ‘Please provide a description, a potential diagnosis, and treatment options for the following dermatological condition’. The generated responses were assessed by senior registrars in dermatology and consultant dermatologists in terms of accuracy, relevance, and depth (scale 1–5), and in addition, the image quality was rated (scale 0–10). Demographic and professional information about the respondents was registered.A total of 23 physicians participated in the study. The majority of the respondents were consultant dermatologists (83%), and 48% had more than 10 years of training. The overall image quality had a median rating of 10 out of 10 [interquartile range (IQR): 9–10]. The overall median rating of the ChatGPT generated responses was 2 (IQR: 1–4), while overall median ratings in terms of relevance, accuracy, and depth were 2 (IQR: 1–4), 3 (IQR: 2–4) and 2 (IQR: 1–3), respectively.Despite the advancements in ChatGPT, including newly added image processing capabilities, the chatbot demonstrated significant limitations in providing reliable and clinically useful responses to illustrative images of various dermatological conditions.

人工智能领域发展迅速。为了评估 ChatGPT 在临床皮肤病学中作为诊断工具和信息来源的作用，我们从丹麦网络地图集 Danderm 中选取了 15 幅临床图片，描述了各种常见和罕见的皮肤病。这些图片被上传到 ChatGPT 版本 GPT-4 中，并提示 "请提供以下皮肤病的描述、潜在诊断和治疗方案"。生成的回答由皮肤科高级注册医师和皮肤科顾问医师从准确性、相关性和深度（1-5 级）方面进行评估，此外，还对图像质量进行了评分（0-10 级）。共有 23 名医生参与了这项研究。大部分受访者是皮肤科顾问医生（83%），48%的受访者接受过 10 年以上的培训。总体图像质量评分的中位数为 10 分（满分 10 分）[四分位数间距（IQR）：9-10]。ChatGPT 生成的回复的总体评分中值为 2（IQR：1-4），而相关性、准确性和深度方面的总体评分中值分别为 2（IQR：1-4）、3（IQR：2-4）和 2（IQR：1-3）。尽管 ChatGPT 取得了进步，包括新增加了图像处理功能，但聊天机器人在为各种皮肤病的说明性图像提供可靠和临床有用的回复方面仍有很大的局限性。

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引用次数: 0

Usage of digital information and communications technologies in patients with hidradenitis suppurativa 化脓性扁桃体炎患者使用数字信息和通信技术的情况

JEADV clinical practice

Pub Date : 2024-06-02 DOI: 10.1002/jvc2.474

Nadja H. Pedersen, V. Nielsen, Nikolaj Holgersen, Nana A. L. Rosenø, J. Thyssen, A. Egeberg, M. Maurer, I. Chérrez-Ojeda, Hans C. Ring, S. F. Thomsen

引用次数: 0

Closing the gap in dermatology training: Introducing Skin of Colour Training UK 缩小皮肤科培训的差距：介绍英国有色人种培训中心

JEADV clinical practice

Pub Date : 2024-06-02 DOI: 10.1002/jvc2.468

Dominique Dao, Oluwadamilola Jagun, Shahd Elamin, Dijon Millette, Hannah Wainman, Cher-Han Tan, Marisa Taylor

The 2021 UK census revealed that the skin of colour (SOC) population increased from a little over 7.8 to 10.9 million in the last 10 years.¹ Despite this, SOC images are underrepresented in medical education,² and research has shown that 54% of Dermatology trainees in the UK lacked confidence in managing SOC-related conditions, echoing similar findings amongst Dermatology trainees in the US and Australia with similar population shifts.^3-5 Additionally, 86% of UK dermatologists felt inadequately trained in managing hyperpigmentation, a prevalent concern in SOC.⁶

It is imperative that dermatological conditions are adequately diagnosed and managed to reduce potential health inequalities in SOC patients. SOC education can be evaluated via SOC-related didactics, dedicated SOC rotation or rotations in which residents primarily see SOC patients.⁷ In Australia, a survey done 5 years after the introduction of SOC learning objectives to the national training curriculum, specifically showed the largest increase in confidence in the management of vitiligo (43%–61%) between 2017 and 2022.⁸ Overall, however, there was a reduction in the confidence in the overall management of SOC conditions from 36% to 32% between 2017 and 2022. This highlighted a need to vary the training delivery methods to include face-to-face interactions, as up till that point; the newly introduced SOC-related content was provided via didactic lectures and case presentations at the annual Australasian Dermatology Meeting.

To bridge this knowledge gap highlighted in the UK surveys above, SOC competencies were added to the UK Dermatology Syllabus Guidance in 2021 and Skin of Colour Training UK (SOCTUK) was set up to train the UK workforce comprising of dermatologists, general practitioners, and other healthcare professionals.

Between 2021 and 2023, three virtual annual training events, supported by the British Association of Dermatologists, were organised. These focussed on common SOC dermatological presentations as highlighted by previous publications, delegate feedback and the updated dermatology syllabus recommendations. In 2022, the event occurred over 2 days, and in 2023, workshops, oral presentations and a poster walk by medical students were incorporated into the programme.

The data were analysed from post-conference surveys over the years (Figures 1 and 2). Responses were obtained from 71.1% (2021), 69.2% (2022) and 53% (2023) of delegates of whom 73.6% (2021), 65.1% (2022), 78.8% (2023) were dermatology doctors (i.e., Consultants, Specialist, Associate Specialist and Specialty (SAS) and Registrars) and 8.6% (2021), 11.2% (2022) 5.3% (2023) were General Practitioner doctors (i.e., GP's and GP Registrars).

Following our inaugural meeting, 85.1% reported that their goal of learning about and managing SOC condit

2021 年英国人口普查显示，在过去 10 年中，英国有色皮肤（SOC）人口从 780 多万增加到 1090 万。1 尽管如此，SOC 形象在医学教育中的代表性仍然不足，2 研究表明，54% 的英国皮肤科受训人员对处理 SOC 相关病症缺乏信心，这与人口变化相似的美国和澳大利亚皮肤科受训人员的研究结果相吻合。此外，86% 的英国皮肤科医生认为在处理色素沉着方面没有接受过充分的培训，而色素沉着是 SOC 患者普遍关注的问题。6 皮肤科疾病必须得到充分的诊断和管理，以减少 SOC 患者潜在的健康不平等。可以通过与 SOC 相关的教学、专门的 SOC 轮转或住院医师主要接诊 SOC 患者的轮转来评估 SOC 教育。7 在澳大利亚，在国家培训课程中引入 SOC 学习目标 5 年后所做的一项调查特别显示，在 2017 年至 2022 年期间，对白癜风管理的信心增幅最大（43%-61%）。这突显出有必要改变培训方法，将面对面互动纳入其中，因为在此之前，新引入的 SOC 相关内容都是在澳大拉西亚皮肤病学年会上通过授课和病例介绍提供的。为了弥补上述英国调查中强调的知识差距，2021 年，英国皮肤病学教学大纲指南中增加了 SOC 能力，并成立了英国有色皮肤培训中心（SOCTUK），以培训由皮肤科医生、全科医生和其他医疗保健专业人员组成的英国工作人员。2021 年至 2023 年期间，在英国皮肤科医生协会的支持下，组织了三次虚拟年度培训活动。2021 年至 2023 年期间，在英国皮肤科医师协会的支持下，组织了三次虚拟年度培训活动，重点关注以往出版物、代表反馈和更新的皮肤科教学大纲建议中强调的常见 SOC 皮肤病表现。2022 年的培训活动为期两天，2023 年的培训活动增加了研讨会、口头报告和医学生海报展示。71.1%（2021 年）、69.2%（2022 年）和 53%（2023 年）的参会代表做出了答复，其中 73.6%（2021 年）、65.1%（2022 年）和 78.8%（2023 年）的参会代表为皮肤科医生（即顾问、专科医生、副专科医生、专科医生（SAS）和注册医生），8.6%（2021 年）、11.2%（2022 年）和 5.3%（2023 年）的参会代表为全科医生（即全科医生和全科注册医生）、在我们的首次会议之后，85.1% 的人表示他们完全达到了学习和管理 SOC 病症的目标，14.2% 的人表示部分达到了目标，0.7% 的人表示没有达到目标。98.6%（2021 年）、98.3%（2022 年）和 97.7%（2023 年）的与会者认为会议内容良好或优秀；96.4%（2021 年）、95.8%（2022 年）和 95.2%（2023 年）的与会者认为会议主题范围良好或优秀；93.3%（2021 年）、95.3%（2022 年）和 96.9%（2023 年）的与会者认为会议主题对临床实践有用。摘要和演讲的结合提供了不同的视角，而研讨会则允许进行小组教学。然而，会议的虚拟性带来了技术故障问题，这对我们 2023 年的会议影响最大，并反映在反馈意见中。可以通过现场会议来克服这一问题，这样可以更好地集中精力和互动，尤其是在研讨会上。总之，SOCTUK 的引入有助于将急需的相关知识转化为临床实践，为医生提供必要的工具，使其能够自信地管理 SOC 患者。

{"title":"Closing the gap in dermatology training: Introducing Skin of Colour Training UK","authors":"Dominique Dao, Oluwadamilola Jagun, Shahd Elamin, Dijon Millette, Hannah Wainman, Cher-Han Tan, Marisa Taylor","doi":"10.1002/jvc2.468","DOIUrl":"10.1002/jvc2.468","url":null,"abstract":"<p>The 2021 UK census revealed that the skin of colour (SOC) population increased from a little over 7.8 to 10.9 million in the last 10 years.<span><sup>1</sup></span> Despite this, SOC images are underrepresented in medical education,<span><sup>2</sup></span> and research has shown that 54% of Dermatology trainees in the UK lacked confidence in managing SOC-related conditions, echoing similar findings amongst Dermatology trainees in the US and Australia with similar population shifts.<span><sup>3-5</sup></span> Additionally, 86% of UK dermatologists felt inadequately trained in managing hyperpigmentation, a prevalent concern in SOC.<span><sup>6</sup></span></p><p>It is imperative that dermatological conditions are adequately diagnosed and managed to reduce potential health inequalities in SOC patients. SOC education can be evaluated via SOC-related didactics, dedicated SOC rotation or rotations in which residents primarily see SOC patients.<span><sup>7</sup></span> In Australia, a survey done 5 years after the introduction of SOC learning objectives to the national training curriculum, specifically showed the largest increase in confidence in the management of vitiligo (43%–61%) between 2017 and 2022.<span><sup>8</sup></span> Overall, however, there was a reduction in the confidence in the overall management of SOC conditions from 36% to 32% between 2017 and 2022. This highlighted a need to vary the training delivery methods to include face-to-face interactions, as up till that point; the newly introduced SOC-related content was provided via didactic lectures and case presentations at the annual Australasian Dermatology Meeting.</p><p>To bridge this knowledge gap highlighted in the UK surveys above, SOC competencies were added to the UK Dermatology Syllabus Guidance in 2021 and Skin of Colour Training UK (SOCTUK) was set up to train the UK workforce comprising of dermatologists, general practitioners, and other healthcare professionals.</p><p>Between 2021 and 2023, three virtual annual training events, supported by the British Association of Dermatologists, were organised. These focussed on common SOC dermatological presentations as highlighted by previous publications, delegate feedback and the updated dermatology syllabus recommendations. In 2022, the event occurred over 2 days, and in 2023, workshops, oral presentations and a poster walk by medical students were incorporated into the programme.</p><p>The data were analysed from post-conference surveys over the years (Figures 1 and 2). Responses were obtained from 71.1% (2021), 69.2% (2022) and 53% (2023) of delegates of whom 73.6% (2021), 65.1% (2022), 78.8% (2023) were dermatology doctors (i.e., Consultants, Specialist, Associate Specialist and Specialty (SAS) and Registrars) and 8.6% (2021), 11.2% (2022) 5.3% (2023) were General Practitioner doctors (i.e., GP's and GP Registrars).</p><p>Following our inaugural meeting, 85.1% reported that their goal of learning about and managing SOC condit","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 3","pages":"917-919"},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141273677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Merkel cell carcinoma data for patients in Miami, Florida: A retrospective analysis 佛罗里达州迈阿密市梅克尔细胞癌患者的数据：回顾性分析

JEADV clinical practice

Pub Date : 2024-06-02 DOI: 10.1002/jvc2.475

Kayla D. Mashoudy, Anil Dalling, Caitlin Dowell‐Esquivel, Peyton V Warp, Robert S. Kirsner

引用次数: 0

Digital imaging of ink spot lentigo: Confocal microscopy and line-field confocal optical coherence tomography assessment 墨点型白斑的数字成像：共聚焦显微镜和线场共聚焦光学相干断层扫描评估

JEADV clinical practice

Pub Date : 2024-05-28 DOI: 10.1002/jvc2.471

Marisa Salvi, Simone Cappilli, Costantino Ricci, Gerardo Palmisano, Alessandro Di Stefani, Ketty Peris

<p>The reticulated black solar lentigo was initially described by Bolognia et al. in 1992 as a type of solar lentigo.<span><sup>1</sup></span> Ink spot lentigo (ISL), as commonly known, clinically presents as a solitary dark pigmented macule with ill-defined margins occurring on the back of fair skin individuals. Due to the peculiar appearance and the common association with multiple solar lentigos, ISL may be difficult to differentiate from melanoma.<span><sup>1, 2</sup></span> Dermoscopy may show criteria similar to those observed in melanocytic lesions as an irregular thick pigment network, angulated lines and rhomboidal structures, and in these cases biopsy should be considered to rule out malignancy.<span><sup>2, 3</sup></span> The use of noninvasive imaging techniques, like reflectance confocal microscopy (RCM), increases the diagnostic accuracy of equivocal skin lesions, allowing to obtain greater performances than dermoscopy alone.<span><sup>4, 5</sup></span> A new digital tool, Line-field confocal optical coherence tomography (LC-OCT), is capable to acquire images/videos of skin lesions in multimodal view (vertical and horizontal), creating also immediate 3D cubes.<span><sup>6</sup></span> Pivotal studies reported promising preliminary data for the in vivo diagnosis of skin cancers.<span><sup>6-8</sup></span></p><p>We report RCM and LC-OCT morphological features of consecutive ISLs, correlating in vivo imaging to histopathology. Twenty-five histopathologically confirmed ISLs of 24 patients (14 M, 10 F, mean age: 48 years old, range: 19–82 years old) were investigated by RCM and LC-OCT from January 2023 to January 2024. ISLs were located on the trunk (10/25, 40%), on the face (7/25, 28%), on the lower extremities (4/25, 16%) and upper extremities (4/25, 16%). Dermoscopy showed atypical (thick, unevenly distributed) pigment network with sharp margins (23/25, 92%), and angulated lines (5/25, 20%) (Figures 1 and 2). RCM mosaics and horizontal sections of LC-OCT displayed densely packed, round to polymorphous edged papillae (24/25, 96%) at dermal-epidermal junction (DEJ), variably associated to bright cords with bulbous projections (19/25, 76%); focal distribution of plump, bright cells in the papillary dermis (20/25, 80%) and keratin-filled invaginations (3/25, 12%) in the upper layers of epidermis (Figure 1). Vertical LC-OCT mode revealed a bright continuous junction (25/25) with evident tubular elongations downward in the dermis (23/25); 3D reconstructions highlighted the presence of architectural changes at the DEJ with a regular epidermis (Figure 2). Criteria indicating melanocytic nature of ISL were not seen either with RCM or with LC-OCT.</p><p>In our ISLs series, RCM and LC-OCT allowed the clear recognition of typical features associated to a solar lentigo, confirming the benign nature of the lesion.<span><sup>6, 9</sup></span> The RCM findings are in line with a single case-report recently described by Venturi et al., observing RCM f

网状黑色日光性白斑最初是由 Bolognia 等人于 1992 年描述的一种日光性白斑。1 墨斑性白斑（ISL），通常被称为墨斑性白斑，临床表现为发生在皮肤白皙者背部的边缘不清的单发深色色素斑。1、2 皮肤镜检查可显示与黑色素细胞病变相似的标准，如不规则的厚色素网、成角线和斜方形结构，在这些情况下应考虑活检以排除恶性肿瘤、3 使用非侵入性成像技术，如反射共聚焦显微镜（RCM），可提高对模糊皮肤病变的诊断准确性，从而获得比单纯皮肤镜更高的性能、5 一种新的数字工具--线场共聚焦光学相干断层扫描（LC-OCT）--能够以多模态视角（垂直和水平）获取皮肤病变的图像/视频，还能立即创建三维立方体。从 2023 年 1 月到 2024 年 1 月，我们通过 RCM 和 LC-OCT 对 24 名患者（14 名男性，10 名女性，平均年龄：48 岁，范围：19-82 岁）的 25 例经组织病理学证实的 ISL 进行了研究。ISL 位于躯干（10/25，40%）、面部（7/25，28%）、下肢（4/25，16%）和上肢（4/25，16%）。皮肤镜检查显示，色素网不典型（厚，分布不均），边缘锐利（23/25，92%），线条成角（5/25，20%）（图 1 和图 2）。RCM 马赛克和 LC-OCT 水平切片显示，在真皮-表皮交界处（DEJ）有密集、圆形至多形性边缘乳头（24/25，96%），不同程度地与带有球状突起的明亮条索相关联（19/25，76%）；在乳头状真皮层有局灶性分布的丰满、明亮细胞（20/25，80%），在表皮上层有充满角蛋白的内陷（3/25，12%）（图 1）。垂直 LC-OCT 模式显示出明亮的连续交界处（25/25），真皮向下有明显的管状伸长（23/25）；三维重建突出显示了 DEJ 处的结构变化和规则的表皮（图 2）。在我们的 ISLs 系列中，RCM 和 LC-OCT 可以清楚地识别与日光性白斑相关的典型特征，从而确认病变的良性性质。6、9 RCM 的发现与 Venturi 等人最近描述的一个病例报告一致，他们观察到 RCM 的特征是环状模式，边缘有乳头状突起、白色网状胶原和小的炎性细胞。9 与只能提供深度为 150-200 µm 的水平方向图像的 RCM 相比，LC-OCT 即使在垂直和三维模式下也能检测到深度达 500 µm 的皮损特征，与经典的组织病理学视角非常相似。在这一系列病例中，LC-OCT 可以清楚地识别 ISL 的主要组织病理学标准、表皮的色素性增生和基底层的色素沉着（在细长的齿嵴顶端非常明显），能够再现 "虚拟活检"，在体内检测出这一实体的关键线索。由于数字成像技术是皮肤镜检查和组织病理学检查之间的桥梁，因此它对解释有疑问的皮肤病变具有重要的诊断价值，在处理 ISL 时通常会出现这种情况、Marisa Salvi、Alessandro Di Stefani 和 Simone Cappilli：构思；Gerardo Palmisano 和 Costantino Ricci：方法；Marisa Salvi 和 Simone Cappilli：原稿编写；Alessandro Di Stefani 和 Ketty Peris：审阅和编辑；Ketty Peris：指导。所有作者均已阅读并同意稿件的出版版本。佩里斯在所提交的工作之外，还从艾伯维、Almirall、百健、Celgene、杨森高德美、诺华、礼来、诺华、皮埃尔法布尔、山德士、赛诺菲和太阳制药公司获得咨询费和酬金。其余作者声明没有利益冲突。本研究根据《赫尔辛基宣言》进行。本手稿中的所有患者均已书面知情同意参与本研究，并同意将其去标识化、匿名化的汇总数据及其病例详情（包括照片）用于发表。

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引用次数: 0

A dermocosmetic regimen is effective and safe for mild to moderate acne in subjects of all skin phototypes 皮肤美容疗法对所有皮肤类型的轻度至中度痤疮都有效且安全

JEADV clinical practice

Pub Date : 2024-05-27 DOI: 10.1002/jvc2.436

Frédéric Flament, Beata Imko-Walczuk, Abdool Aslham Doarika, Elodie Prestat-Marquis, Romain Biassin, Margot Nioré, Ludivine Canchy, Jerry Tan

Background

Acne vulgaris is a chronic inflammatory skin condition with a multifactorial pathogenesis. The clinical appearance of acne and its sequelae may differ according to phototypes. Data regarding the potential benefit of dermocosmetics (DC) regardless of phototype are lacking and assessing acne improvement can be difficult, given the lack of visual support in people with skin of colour. A DC regimen, combining a cleanser and a cream, both containing thermal spring water, has been developed for the management of mild-to-moderate acne, for all skin phototypes studied.

Objectives

To assess the efficacy and local tolerance of a DC routine in mild-to-moderate acne and to visualize the clinical improvement in all skin phototypes.

Methods

In an open-labelled, multicentre clinical study, subjects of any phototype aged above 11 years and above with mild (N = 48, 55.2%) or moderate (N = 39, 44.8%) facial acne applied the DC twice daily for 56 days. No other acne care was allowed. Acne severity, as well as inflammatory and noninflammatory lesion counts, were assessed at baseline, Days 28 and 56. Photographs were taken using a novel imaging tool based on multimodal acquisition, to show clinical improvement over time.

Results

Eighty-seven subjects, 41 adults and 46 adolescents, were included; 59.8% were female and were aged between 11 and 44 years. The total acne lesion count decreased by 34%, the noninflammatory lesion count by 28%, and the inflammatory lesion count by 52% at Day 56. All % changes were statistically significant (p < 0.05). The GEA score decreased, with 25% of subjects showing at least a one-grade improvement at Day 28 and 59% at Day 56. Local tolerance was excellent.

Conclusions

The tested DC care is beneficial for the improvement of acne and is very well tolerated in all skin phototypes studied.

背景：寻常痤疮是一种慢性炎症性皮肤病，其发病机制是多因素的。痤疮的临床表现及其后遗症可能因光照类型而异。由于缺乏对有色人种皮肤的视觉支持，评估痤疮改善情况可能比较困难。目前已开发出一种含温泉水的洗面奶和面霜组合的皮肤美容疗法，用于治疗轻度至中度痤疮，适用于所有皮肤类型。目标评估轻度至中度痤疮患者使用直流电疗法的疗效和局部耐受性，并观察所有皮肤类型的临床改善情况。方法在一项开放标签的多中心临床研究中，年龄在 11 岁以上、面部有轻度（48 人，占 55.2%）或中度（39 人，占 44.8%）痤疮的任何肤质的受试者每天使用两次 DC，持续 56 天。不允许使用其他痤疮护理方法。在基线、第 28 天和第 56 天评估痤疮严重程度以及炎性和非炎性皮损数量。使用基于多模态采集的新型成像工具拍摄照片，以显示随时间推移的临床改善情况。结果共有 87 名受试者，其中 41 人为成年人，46 人为青少年；59.8% 为女性，年龄在 11 至 44 岁之间。第 56 天时，痤疮皮损总数减少了 34%，非炎症性皮损减少了 28%，炎症性皮损减少了 52%。所有百分比的变化均有统计学意义（P < 0.05）。GEA 评分有所下降，25% 的受试者在第 28 天时的评分至少提高了一个等级，59% 的受试者在第 56 天时的评分提高了一个等级。局部耐受性极佳。结论测试的 DC 护理对痤疮的改善很有帮助，而且所有皮肤类型的受试者都能很好地耐受。

{"title":"A dermocosmetic regimen is effective and safe for mild to moderate acne in subjects of all skin phototypes","authors":"Frédéric Flament, Beata Imko-Walczuk, Abdool Aslham Doarika, Elodie Prestat-Marquis, Romain Biassin, Margot Nioré, Ludivine Canchy, Jerry Tan","doi":"10.1002/jvc2.436","DOIUrl":"https://doi.org/10.1002/jvc2.436","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acne vulgaris is a chronic inflammatory skin condition with a multifactorial pathogenesis. The clinical appearance of acne and its sequelae may differ according to phototypes. Data regarding the potential benefit of dermocosmetics (DC) regardless of phototype are lacking and assessing acne improvement can be difficult, given the lack of visual support in people with skin of colour. A DC regimen, combining a cleanser and a cream, both containing thermal spring water, has been developed for the management of mild-to-moderate acne, for all skin phototypes studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the efficacy and local tolerance of a DC routine in mild-to-moderate acne and to visualize the clinical improvement in all skin phototypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In an open-labelled, multicentre clinical study, subjects of any phototype aged above 11 years and above with mild (<i>N</i> = 48, 55.2%) or moderate (<i>N</i> = 39, 44.8%) facial acne applied the DC twice daily for 56 days. No other acne care was allowed. Acne severity, as well as inflammatory and noninflammatory lesion counts, were assessed at baseline, Days 28 and 56. Photographs were taken using a novel imaging tool based on multimodal acquisition, to show clinical improvement over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-seven subjects, 41 adults and 46 adolescents, were included; 59.8% were female and were aged between 11 and 44 years. The total acne lesion count decreased by 34%, the noninflammatory lesion count by 28%, and the inflammatory lesion count by 52% at Day 56. All % changes were statistically significant (<i>p</i> < 0.05). The GEA score decreased, with 25% of subjects showing at least a one-grade improvement at Day 28 and 59% at Day 56. Local tolerance was excellent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The tested DC care is beneficial for the improvement of acne and is very well tolerated in all skin phototypes studied.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 4","pages":"1140-1147"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142123365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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