33 results on '"Soyer HP."'
Search Results
2. In vivo confocal microscopic pattern of fibroepithelioma of pinkus.
- Author
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Longo C, Soyer HP, Pepe P, Casari A, Wurm EM, Guitera P, and Pellacani G
- Subjects
- Humans, Carcinoma, Basal Cell pathology, Microscopy, Confocal, Skin Neoplasms pathology
- Published
- 2012
- Full Text
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3. Factors contributing to incomplete excision of nonmelanoma skin cancer by Australian general practitioners.
- Author
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Hansen C, Wilkinson D, Hansen M, and Soyer HP
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Ambulatory Surgical Procedures, Australia, Biopsy, Needle, Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell pathology, Child, Confidence Intervals, Family Practice standards, Family Practice trends, Female, Health Care Surveys, Humans, Immunohistochemistry, Male, Middle Aged, Physicians, Family, Practice Patterns, Physicians', Probability, Risk Factors, Sex Factors, Skin Neoplasms pathology, Treatment Outcome, Young Adult, Carcinoma, Basal Cell surgery, Carcinoma, Squamous Cell surgery, Clinical Competence, Dermatology methods, Skin Neoplasms surgery
- Abstract
Objective: To study rates of incomplete excision of basal (BCC) and squamous (SCC) cell cancer by Australian general practitioners with a special interest., Design: Records review., Setting: A network of 15 primary care skin cancer clinics across Australia., Participants: Fifty-seven physicians performing excisions of 9417 BCCs and SCCs in a single network of 15 primary care skin cancer clinics across Australia between 2005 and 2007., Main Outcome Measures: Rates of incomplete excision according to physician, clinic, anatomic location of the lesion, and whether a previous biopsy had been performed., Results: Four hundred forty-three of 6881 BCCs (6.4%) and 159 of 2536 SCCs (6.3%) were excised incompletely. Incomplete BCC and SCC excisions were more frequent on the head and neck (282 of 2872 excisions [9.8%] and 97 of 861 [11.3%], respectively) than elsewhere. Ears (74 of 388 excisions [19.1%]) and nose (78 of 546 [14.3%]) had the highest rates of incompletely excised BCCs, and ears (26 of 144 excisions [18.1%]) and forehead (20 of 157 [12.7%]) had the highest rates of incompletely excised SCCs. Of all BCC excisions, 67.3% were once-off excisions with no previous biopsy, and these excisions were more likely to be incomplete (odds ratio, 1.73; 95% confidence interval, 1.36-2.20) than those with a previous biopsy. There was, however, substantial variation in frequency of incomplete excision between clinics for BCC (ranging from 3.3% to 24.7%) and SCC (ranging from 0% to 17.2%) and between physicians within clinics (BCC ranging from 0% to 31.1%, and SCC ranging from 0% to 23.5%)., Conclusions: Overall frequency of incomplete excision is low and similar to that in other reports. However, high frequency in high-risk sites, low rates of previous biopsy, and substantial variation in performance between physicians and clinics suggests there is significant opportunity to further improve health outcomes.
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- 2009
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4. Clinical and dermoscopic features of porokeratosis of Mibelli.
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Pizzichetta MA, Canzonieri V, Massone C, and Soyer HP
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- Adolescent, Dermoscopy, Humans, Male, Porokeratosis pathology, Skin pathology
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- 2009
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5. Three roots of melanoma.
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Zalaudek I, Marghoob AA, Scope A, Leinweber B, Ferrara G, Hofmann-Wellenhof R, Pellacani G, Soyer HP, and Argenziano G
- Subjects
- Biopsy, Needle, Cell Transformation, Neoplastic pathology, Epidermis pathology, Epidermis ultrastructure, Humans, Immunohistochemistry, Microscopy, Confocal, Models, Theoretical, Precancerous Conditions pathology, Risk Assessment, Sensitivity and Specificity, Stem Cells ultrastructure, Hutchinson's Melanotic Freckle pathology, Melanoma pathology, Skin Neoplasms pathology, Stem Cells pathology
- Published
- 2008
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6. Dermoscopic evaluation of amelanotic and hypomelanotic melanoma.
- Author
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Menzies SW, Kreusch J, Byth K, Pizzichetta MA, Marghoob A, Braun R, Malvehy J, Puig S, Argenziano G, Zalaudek I, Rabinovitz HS, Oliviero M, Cabo H, Ahlgrimm-Siess V, Avramidis M, Guitera P, Soyer HP, Ghigliotti G, Tanaka M, Perusquia AM, Pagnanelli G, Bono R, Thomas L, Pellacani G, Langford D, Piccolo D, Terstappen K, Stanganelli I, Llambrich A, and Johr R
- Subjects
- Diagnosis, Differential, Humans, Models, Biological, Observer Variation, Predictive Value of Tests, Sensitivity and Specificity, Dermoscopy, Melanoma pathology, Melanoma, Amelanotic pathology, Skin Neoplasms pathology, Skin Pigmentation
- Abstract
Objective: To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma., Design: A total of 105 melanomas (median Breslow thickness, 0.76 mm), 170 benign melanocytic lesions, and 222 nonmelanocytic lesions lacking significant pigment (amelanotic, partially pigmented, and light colored) were imaged using glass-plate dermoscopy devices and scored for 99 dermoscopic features. Diagnostic models were derived from and tested on independent randomly selected lesions., Setting: Predominantly hospital-based clinics from 5 continents., Main Outcome Measures: Sensitivity, specificity, and odds ratios for individual features and models for the diagnosis of melanoma and malignancy., Results: The most significant negative predictors of melanoma were having multiple (>3) milialike cysts (odds ratio, 0.09; 95% confidence interval, 0.01-0.64), comma vessels with a regular distribution (0.10; 0.01-0.70), comma vessels as the predominant vessel type (0.16; 0.05-0.52), symmetrical pigmentation pattern (0.18; 0.09-0.39), irregular blue-gray globules (0.20; 0.05-0.87), and multiple blue-gray globules (0.28; 0.10-0.81). The most significant positive predictors were having a blue-white veil (odds ratio,13; 95% confidence interval, 3.9-40.0), scarlike depigmentation (4.4; 2.4-8.0), multiple blue-gray dots (3.5; 1.9-6.4), irregularly shaped depigmentation (3.3; 2.0-5.3), irregular brown dots/globules (3.2; 1.8-5.6), 5 to 6 colors (3.2; 1.6-6.3), and predominant central vessels (3.1; 1.6-6.0). A simple model distinguishing melanomas from all nonmelanomas had a sensitivity of 70% and a specificity of 56% in the test set. A model distinguishing all malignant lesions from benign lesions had a sensitivity of 96% and a specificity of 37%. Conclusion Although the diagnostic accuracy of dermoscopy for melanoma lacking significant pigment is inferior to that of more pigmented lesions, features distinguishing the former from benign lesions can be visualized on dermoscopic evaluation.
- Published
- 2008
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7. Teledermatological monitoring of leg ulcers in cooperation with home care nurses.
- Author
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Binder B, Hofmann-Wellenhof R, Salmhofer W, Okcu A, Kerl H, and Soyer HP
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- Aged, Aged, 80 and over, Feasibility Studies, Female, Health Care Costs, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Remote Consultation, Dermatology methods, Home Care Services, Leg Ulcer therapy, Nurses, Population Surveillance methods, Telemedicine
- Abstract
Objectives: To examine the feasibility and acceptance of teledermatology for wound management for patients with leg ulcers by home care nurses and evaluate the reduction of costs and the acceptance of teledermatology by patients and home care nurses., Design: Case series of telemonitored patients with leg ulcers including cost-effectiveness analysis., Setting: Home monitoring by home care nurses., Patients: Sixteen patients with 45 leg ulcers of different origin were included., Main Outcome Measures: After an initial outpatient visit when the leg ulcers were assessed and classified, teledermatological follow-up was done by home care nurses. Relevant clinical information and 1 to 4 digital images of the wound and surrounding skin were transmitted weekly via a secure Web site to an expert at the wound care center, who assessed the wound and made therapeutic recommendations., Results: Of the 707 images transmitted for teleconsultation, in 644 (89%) the quality of the images was excellent or sufficient and the experts were confident in giving therapeutic recommendations. Of the 45 ulcers, 32 (71%) decreased in size and 14 (31%) healed completely, whereas 10 of the 45 ulcers (22%) increased slightly in size despite the teledermatological monitoring. In 3 ulcers (7%), no measurement was possible owing to the overly large size of the ulcers. The acceptance of telemedicine was very good by most patients. Of 15 home care nurses working in the district, 7 were very satisfied with teledermatological monitoring of wound care. There was a reduction of 46% in transportation costs for the insurance companies as well as for the patients owing to a significant decrease in the number of visits to general physicians or the wound care center., Conclusions: The acceptance of teledermatological monitoring of wound care was very high by patients, home care nurses, and wound experts. Decreased health care costs by reducing the number of visits to wound care centers or specialist physicians and improvement in quality of life for patients with leg ulcers using telemedicine seems possible. Teledermatology offers great potential for long-term wound care.
- Published
- 2007
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8. Clinical and dermoscopic features of agminated blue nevus.
- Author
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Pizzichetta MA, Soyer HP, Massone C, and Cerroni L
- Subjects
- Female, Humans, Middle Aged, Nevus, Blue pathology, Skin Neoplasms pathology, Dermoscopy, Nevus, Blue diagnosis, Skin Neoplasms diagnosis
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- 2007
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9. Involution: the natural evolution of pigmented Spitz and Reed nevi?
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Argenziano G, Zalaudek I, Ferrara G, Lorenzoni A, and Soyer HP
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- Child, Child, Preschool, Dermoscopy, Humans, Male, Remission, Spontaneous, Nevus, Pigmented pathology, Skin Neoplasms pathology
- Published
- 2007
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10. Nevus type in dermoscopy is related to skin type in white persons.
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Zalaudek I, Argenziano G, Mordente I, Moscarella E, Corona R, Sera F, Blum A, Cabo H, Di Stefani A, Hofmann-Wellenhof R, Johr R, Langford D, Malvehy J, Kolm I, Sgambato A, Puig S, Soyer HP, and Kerl H
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Humans, Male, Middle Aged, Dermoscopy, Nevus, Pigmented classification, Nevus, Pigmented pathology, Skin Neoplasms classification, Skin Neoplasms pathology, White People
- Abstract
Background: Dermoscopic classification of acquired melanocytic nevi (AMN) is based on the evaluation of 3 main criteria-global pattern, pigment distribution, and color., Objective: To determine whether these features are different in AMN in white people with different skin types (STs) according to the Fitzpatrick classification., Design: Digital dermoscopic images of AMN were evaluated, and the correlation of the 3 main dermoscopic criteria with patient ST was analyzed., Setting: Consecutive patients were recruited from 7 pigmented lesion clinics between June 1, 2004, and June 30, 2005. Patients For each patient, the ST (I [always burns, never tans] to IV [rarely burns, tans with ease]) was scored, and 1 representative AMN (defined as the AMN showing a dermoscopic typology that is repeatedly seen in the same patient) was selected and photographed., Main Outcome Measures: The distribution of the dermoscopic criteria of AMN in patients with different STs was calculated by univariate analysis. Differences in prevalence were tested using the chi(2) test. The correlation between dermoscopic criteria and ST, adjusted for age, sex, and enrolling center, was evaluated by calculating odds ratios and 95% confidence intervals by logistic regression analysis., Results: Of 680 included patients, dermoscopic analysis revealed significant differences in the prevalent nevus pattern in the 4 ST groups. Light brown AMN with central hypopigmentation were associated with ST I, and ST IV was associated with the so-called black nevus (P<.001), typified by reticular pattern, central hyperpigmentation, and dark brown coloration. A significant association was also found between multifocal pattern and ST II and ST III., Conclusions: The dermoscopic nevus type varies according to different ST in white people. This knowledge may have an effect on obtaining for biopsy lesions that exhibit unusual dermoscopic patterns when patient ST is considered.
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- 2007
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11. Dermoscopy patterns of halo nevi.
- Author
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Kolm I, Di Stefani A, Hofmann-Wellenhof R, Fink-Puches R, Wolf IH, Richtig E, Smolle J, Kerl H, Soyer HP, and Zalaudek I
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- Adolescent, Adult, Child, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Dermoscopy methods, Nevus, Pigmented pathology, Skin Neoplasms pathology
- Abstract
Background: Halo nevi (HN) are benign melanocytic nevi surrounded by a depigmented area (halo). This study aims to evaluate the dermoscopic features of HN and their changes during digital dermoscopic follow-up and to investigate the frequency of the halo phenomenon in a series of melanomas., Observations: In a retrospective study, digital dermoscopic images of HN from patients who attended the Pigmented Skin Lesions Clinic of the Department of Dermatology, Medical University of Graz, between October 1, 1997, and March 31, 2004, were reviewed and classified by dermoscopic morphologic criteria. For HN that were followed up with digital dermoscopy, the percentages of changes in the size of the nevus and halo components were calculated. In addition, digital dermoscopic images of histopathologically confirmed melanomas obtained from the same database were reviewed for the presence of an encircling halolike depigmentation. We classified 138 HN in 87 patients (mean age, 22.4 years). The most common dermoscopic structures were the globular and/or homogeneous patterns in more than 80% of HN. Follow-up of 33 HN revealed considerable size reduction of the nevus component, but this was not associated with significant structural changes. Of a total of 475 melanomas, only 2 revealed an encircling halo, but both displayed clear-cut melanoma-specific patterns according to dermoscopy., Conclusions: Halo nevi exhibit the characteristic dermoscopic features of benign melanocytic nevi, represented by globular and/or homogeneous patterns that are typically observed in children and young adults. Halo nevi reveal considerable changes of area over time during digital dermoscopic follow-up, albeit their structural patterns remain unchanged. For this reason and because melanoma with halolike depigmentation, despite being rare, additionally exhibits melanoma-specific dermoscopic criteria, the role of digital dermoscopic follow-up in the diagnosis of HN is insignificant.
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- 2006
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12. Malignant melanoma in marathon runners.
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Ambros-Rudolph CM, Hofmann-Wellenhof R, Richtig E, Müller-Fürstner M, Soyer HP, and Kerl H
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- Adult, Aged, Austria epidemiology, Case-Control Studies, Female, Humans, Male, Melanoma etiology, Melanoma pathology, Melanoma prevention & control, Middle Aged, Phenotype, Pilot Projects, Protective Clothing, Skin Neoplasms etiology, Skin Neoplasms pathology, Skin Neoplasms prevention & control, Sunlight adverse effects, Sunscreening Agents, Melanoma epidemiology, Running, Skin Neoplasms epidemiology
- Abstract
Background: Marathon running has surged in popularity; it is generally believed to be healthy, but may be associated with medical risks. Over the past decade, we observed 8 ultramarathon runners with malignant melanoma. UV exposure, immunosuppression due to long-term intensive exercise, or both have been discussed as potential triggers in these patients. To further evaluate risk factors for malignant melanoma in marathon runners, we examined anamnestic, phenotypic, sun-related, and clinical variables in 210 athletes and compared them with those of an age- and sex-matched control group., Observations: Although control subjects exhibited higher sun sensitivity and more common melanocytic nevi, marathon runners presented with more atypical melanocytic nevi, solar lentigines, and lesions suggestive of nonmelanoma skin cancer. These findings correlated with increasing training intensity. During exercising, most runners wore shorts (96.7%) and shirts (98.6%) that would not or would only partially cover their back and extremities. Regular use of sunscreen was reported in only 56.2% of runners., Conclusions: Compared with a representative control group, marathon runners presented with an increased risk for malignant melanoma and nonmelanoma skin cancer. They should reduce UV exposure during exercising by choosing training and competition schedules with low sun exposure, wearing adequate clothing, and regularly using water-resistant sunscreens.
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- 2006
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13. Morphologic changes of acquired melanocytic nevi with eccentric foci of hyperpigmentation ("Bolognia sign") assessed by dermoscopy.
- Author
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Pizzichetta MA, Massone C, Grandi G, Pelizzo G, and Soyer HP
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- Child, Preschool, Dermoscopy methods, Diagnosis, Differential, Female, Humans, Hyperpigmentation pathology, Melanoma diagnosis, Melanoma pathology, Nevus, Pigmented pathology, Skin Neoplasms pathology, Hyperpigmentation diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
- Abstract
Background: Melanocytic nevi with eccentric foci of hyperpigmentation ("Bolognia sign") can be considered as a melanoma-simulating type of acquired melanocytic nevus. We report on the morphologic changes of this type of melanocytic nevus over a 39-month period of dermoscopic follow-up., Observations: A 5-year-old girl had a 4-mm brown papule with a peripheral blue-black area on her right upper arm. The eccentric focus of the hyperpigmentation corresponded dermoscopically to a blue-gray area of pigmentation associated with irregular brown-black globules or dots and partially with a superficial black network. After 39 months, a globular type of acquired melanocytic nevus was detectable, which clinically and dermoscopically appeared to be completely benign. A nearly identical situation was observed in 5 other melanocytic nevi, underlining the involution of the pigmented foci in these nevi. The histopathologic diagnoses of 2 lesions were consistent with a compound type of acquired melanocytic nevus with eccentric foci of hyperpigmentation., Conclusions: Dermoscopy allows identification of a morphologic pathway of modifications, probably typical for this type of melanocytic nevus in children, and therefore enables avoidance of surgical excision with attendant hypertrophic scarring in children. Conversely, in adults, when dermoscopic follow-up of melanocytic nevi reveals eccentric foci of hyperpigmentation, surgical excision of the lesion is indicated.
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- 2006
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14. The spectrum of Spitz nevi: a clinicopathologic study of 83 cases.
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Ferrara G, Argenziano G, Soyer HP, Chimenti S, Di Blasi A, Pellacani G, Peris K, Piccolo D, Rubegni P, Seidenari S, Staibano S, Zalaudek I, and De Rosa G
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- Adolescent, Adult, Child, Child, Preschool, Dermoscopy, Female, Humans, Infant, Italy epidemiology, Male, Medical Records, Middle Aged, Nevus, Epithelioid and Spindle Cell diagnosis, Nevus, Epithelioid and Spindle Cell etiology, Nevus, Epithelioid and Spindle Cell pathology, Retrospective Studies, Skin Neoplasms diagnosis, Skin Neoplasms etiology, Skin Neoplasms pathology, Nevus, Epithelioid and Spindle Cell epidemiology, Skin Neoplasms epidemiology
- Abstract
Objective: To achieve a clinicopathologic classification of Spitz nevi by comparing their clinical, dermoscopic, and histopathologic features., Design: Eighty-three cases were independently reviewed by 3 histopathologists and preliminarily classified into classic or desmoplastic Spitz nevus (CDSN, n = 11), pigmented Spitz nevus (PSN, n = 14), Reed nevus (RN, n = 16), or atypical Spitz nevus (ASN, n = 14); the remaining 28 cases were then placed into an intermediate category (pigmented Spitz-Reed nevus, PSRN) because a unanimous diagnosis of either PSN or RN was not reached., Setting: University dermatology and pathology departments and general hospital pathology departments., Patients: A sample of subjects with excised melanocytic lesions., Main Outcome Measure: Frequency of dermoscopic patterns within the different histopathologic subtypes of Spitz nevi., Results: Overlapping clinical, dermoscopic, and histopathologic findings were observed among PSN, RN, and PSRN, thereby justifying their inclusion into the single PSRN diagnostic category. Asymmetry was the most frequent indicator of histopathologic ASN (79%; n = 11); in only 4 cases did dermoscopic asymmetry show no histopathologic counterpart, and in those cases the discrepancy was probably the result of an artifact of the gross sampling technique carried out with no attention to the dermoscopic features., Conclusions: Among Spitz nevi, histopathologic distinction between PSN and RN is difficult, not reproducible, and may be clinically useless. A simple clinicopathologic classification of these neoplasms might therefore be structured as CDSN, PSRN, and ASN. Asymmetry should be assessed using both dermoscopic and histopathologic analysis, and reliability in histopathologic diagnosis may be enhanced by the simultaneous evaluation of the corresponding dermoscopic images.
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- 2005
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15. Cellular phones in clinical teledermatology.
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Massone C, Lozzi GP, Wurm E, Hofmann-Wellenhof R, Schoellnast R, Zalaudek I, Gabler G, Di Stefani A, Kerl H, and Soyer HP
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- Humans, Photography, Cell Phone instrumentation, Dermatology methods, Skin Diseases diagnosis, Telemedicine
- Published
- 2005
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16. Limitations of histopathologic analysis in the recognition of melanoma: a plea for a combined diagnostic approach of histopathologic and dermoscopic evaluation.
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Soyer HP, Massone C, Ferrara G, and Argenziano G
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- Biopsy, Needle, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Male, Melanoma pathology, Neoplasm Staging, Nevus, Pigmented pathology, Sensitivity and Specificity, Skin Neoplasms pathology, Dermoscopy, Melanoma diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
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- 2005
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17. Vascular structures in skin tumors: a dermoscopy study.
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Argenziano G, Zalaudek I, Corona R, Sera F, Cicale L, Petrillo G, Ruocco E, Hofmann-Wellenhof R, and Soyer HP
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- Adult, Blood Vessels pathology, Erythema etiology, Female, Humans, Male, Melanocytes pathology, Predictive Value of Tests, Skin Neoplasms complications, Dermoscopy, Skin Neoplasms blood supply, Skin Neoplasms pathology
- Abstract
Objectives: To describe the different vascular structures seen by dermoscopy and to evaluate their association with various melanocytic and nonmelanocytic skin tumors in a large series of cases., Design: Digital dermoscopic images of the lesions were evaluated for the presence of various morphologic types of vessels., Setting: Specialized university clinic., Patients: From a larger database, 531 excised lesions (from 517 patients) dermoscopically showing any type of vascular structures were included., Main Outcome Measures: The frequency and positive predictive value of the different vascular structures seen in various tumors were calculated, and the differences were evaluated by the chi2 or Fisher exact test., Results: Arborizing vessels were seen in 82.1% of basal cell carcinomas, with a 94.1% positive predictive value (P<.001). Dotted vessels were generally predictive for a melanocytic lesion (90.0%, P<.001), and were especially seen in Spitz nevi (77.8% of lesions). In melanoma, linear-irregular, dotted, and polymorphous/atypical vessels were the most frequent vascular structures, whereas milky-red globules/areas were the most predictive ones (77.8%, P = .003). The presence of erythema was most predictive for Clark nevus, whereas comma, glomerular, crown, and hairpin vessels were significantly associated with dermal/congenital nevi, Bowen disease, sebaceous hyperplasia, and seborrheic keratosis, respectively (P<.001 for all)., Conclusions: Different morphologic types of vessels are associated with different melanocytic or nonmelanocytic skin tumors. Therefore, the recognition of distinctive vascular structures may be helpful for diagnostic purposes, especially when the classic pigmented dermoscopic structures are lacking.
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- 2004
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18. Melanoma simulating seborrheic keratosis: a major dermoscopy pitfall.
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Argenziano G, Rossiello L, Scalvenzi M, Staibano S, Ruocco E, Cicale L, and Soyer HP
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- Diagnosis, Differential, Humans, Keratosis, Seborrheic pathology, Male, Microscopy, Middle Aged, Thorax, Melanoma pathology, Skin Neoplasms pathology
- Published
- 2003
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19. No detection of human herpesvirus 8 in different types of cutaneous angiosarcoma.
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Fink-Puches R, Zöchling N, Wolf P, Bäck B, Kerl H, and Soyer HP
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- Biopsy, Needle, Blotting, Southern, DNA, Viral analysis, Hemangiosarcoma pathology, Humans, Immunohistochemistry, Polymerase Chain Reaction, Sensitivity and Specificity, Skin Neoplasms pathology, Hemangiosarcoma virology, Herpesvirus 8, Human isolation & purification, Skin Neoplasms virology
- Published
- 2002
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20. Concordance between telepathologic diagnosis and conventional histopathologic diagnosis: a multiobserver store-and-forward study on 20 skin specimens.
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Piccolo D, Soyer HP, Burgdorf W, Talamini R, Peris K, Bugatti L, Canzonieri V, Cerroni L, Chimenti S, De Rosa G, Filosa G, Hoffmann R, Julis I, Kutzner H, Manente L, Misciali C, Schaeppi H, Tanaka M, Tyler W, Zelger B, and Kerl H
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Needle, Child, Culture Techniques, Female, Humans, Male, Middle Aged, Observer Variation, Probability, Sampling Studies, Sensitivity and Specificity, Skin Diseases diagnosis, Immunohistochemistry, Skin Diseases pathology, Telepathology
- Abstract
Objective: To study the validity and feasibility of transferring images of cutaneous biopsy specimens via e-mail to remote physicians active in dermatopathology for teleconsultation., Design: Twenty skin specimens previously diagnosed at the Department of Dermatology, University of Graz, Austria, were subsequently sent for teleconsultation using the store-and-forward method. For each case, 3 or 4 images at different magnifications were sent by e-mail to 16 colleagues (11 dermatopathologists and 5 pathologists) in 15 centers in 6 different countries. Six weeks later each observer received the hematoxylin-eosin-stained specimens to render a conventional diagnosis., Setting: Dermatopathology and pathology units within institutional and private settings., Material: Twenty small skin biopsy specimens of cutaneous diseases were selected randomly from a study set of 80., Main Outcome Measure: Concordance between telepathologic diagnoses and conventional histopathologic diagnoses of 20 skin specimens., Results: On average, 78% of the telediagnoses were correct (range, 60%-95%), whereas 85% of the conventional diagnoses were correct (range, 60%-95%). A perfect diagnostic concordance was obtained in 7 (35%) of 20 cases, and a significant difference was identified in only 1 case., Conclusions: Results suggest that telepathology performed by physicians active in dermatopathology may serve as a reliable technique for the diagnosis of cutaneous diseases when experts in dermatopathology are not available locally. Furthermore, teledermatopathology is attractive because it provides an opportunity to obtain timely consultation on difficult cases.
- Published
- 2002
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21. Dermoscopic classification of atypical melanocytic nevi (Clark nevi).
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Hofmann-Wellenhof R, Blum A, Wolf IH, Piccolo D, Kerl H, Garbe C, and Soyer HP
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- Adolescent, Adult, Aged, Austria, Child, Diagnosis, Differential, Female, Germany, Humans, Male, Middle Aged, Diagnostic Imaging methods, Nevus, Pigmented classification, Nevus, Pigmented pathology, Skin Neoplasms classification, Skin Neoplasms pathology
- Abstract
Objectives: To create a dermoscopic classification of atypical melanocytic nevi (Clark nevi) and to investigate whether individuals bear a predominant type., Design: Digital dermoscopic images of Clark nevi were classified according to structural features, ie, reticular, globular, or homogeneous patterns or combinations of these types. The nevi were also characterized as central hypopigmented or hyperpigmented, eccentric peripheral hypopigmented or hyperpigmented, or multifocal hypopigmented or hyperpigmented., Setting: Two pigmented skin lesion clinics., Patients: We examined 829 Clark nevi on 23 individuals., Main Outcome Measure: A reliable dermoscopic classification of Clark nevi and frequency of different dermoscopic types., Results: Using the dermoscopic classification, the 829 Clark nevi were classified as follows: 221 (26.7%) as reticular, 167 (20.1%) as reticular-homogeneous, 148 (17.9%) as globular-homogeneous, 112 (13.5%) as reticular-globular, 89 (10.7%) as homogeneous, 84 (10.1%) as globular, and 8 (1.0%) as unclassified. Most individuals were prone to a predominant type of Clark nevus. Seven individuals (30%) showed a single type of Clark nevus in more than 50% of their nevi and 5 (22%) in more than 40% of their nevi., Conclusions: The proposed dermoscopic classification of Clark nevi is easily applicable and allows a detailed characterization of the different dermoscopic types of Clark nevi. Knowledge of these dermoscopic types should reduce unnecessary surgery for benign melanocytic lesions. Exact classification of the different types of Clark nevi is a necessary prerequisite for further clinical, dermoscopic, and histopathologic studies, which will give new insights in the biology of acquired melanocytic nevi.
- Published
- 2001
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22. Is dermoscopy useful for the diagnosis of melanoma?
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Soyer HP, Argenziano G, Talamini R, and Chimenti S
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- Diagnosis, Differential, Humans, Microscopy methods, United States, Diagnosis, Computer-Assisted standards, Melanoma pathology, Skin Neoplasms pathology
- Published
- 2001
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23. The ABCD rule of dermatoscopy does not apply to small melanocytic skin lesions.
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Pizzichetta MA, Talamini R, Piccolo D, Argenziano G, Pagnanelli G, Burgdorf T, Lombardi D, Trevisan G, Veronesi A, Carbone A, and Soyer HP
- Subjects
- Diagnosis, Differential, Female, Humans, Male, Melanoma pathology, Microscopy methods, Nevus, Pigmented pathology, Observer Variation, Retrospective Studies, Sensitivity and Specificity, Skin Neoplasms pathology, Diagnostic Imaging standards, Melanoma diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
- Published
- 2001
24. Rudimentary meningocele: remnant of a neural tube defect?
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El Shabrawi-Caelen L, White WL, Soyer HP, Kim BS, Frieden IJ, and McCalmont TH
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- Child, Child, Preschool, Female, Humans, Immunohistochemistry, Infant, Infant, Newborn, Male, Medical Records, Meningocele surgery, Neural Tube Defects pathology, Neural Tube Defects surgery, Retrospective Studies, Meningocele pathology
- Abstract
Background: Rudimentary meningocele, a malformation in which meningothelial elements are present in the skin and subcutaneous tissue, has been described in the past under a variety of different terms and has also been referred to as cutaneous meningioma. There has been debate as to whether rudimentary meningocele is an atretic form of meningocele or results from growth of meningeal cells displaced along cutaneous nerves, Objective: We reviewed the clinical, histological, and immunohistochemical characteristics of rudimentary meningocele in an attempt to assess the most likely pathologic mechanism for it., Design: Retrospective study., Setting: University hospitals., Patients: Thirteen children with rudimentary meningocele., Main Outcome Measures: Medical records were reviewed and histopathologic examination as well as immunohistochemistry studies were performed for each case. A panel of immunoperoxidase reagents (EMA, CD31, CD34, CD57, S-100, and CAM 5.2) was used to assess lineage and to confirm the meningothelial nature of these lesions., Results: Recent evidence indicating a multisite closure of the neural tube in humans suggests that classic meningocele and rudimentary meningocele are on a continuous spectrum., Conclusion: Rudimentary meningocele seems to be a remnant of a neural tube defect in which abnormal attachment of the developing neural tube to skin (comparable to that in classic meningocele) could explain the presence of ectopic meningeal tissue. In the majority of cases, no underlying bony defect or communication to the meninges could be detected. However, in light of the probable pathogenesis, imaging studies to exclude any communication to the central nervous system should precede any invasive evaluation or intervention.
- Published
- 2001
- Full Text
- View/download PDF
25. Herpetic folliculitis and syringitis simulating acne excoriée.
- Author
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Brabek E, El Shabrawi-Caelen L, Woltsche-Kahr I, Soyer HP, and Aberer W
- Subjects
- Acyclovir administration & dosage, Administration, Oral, Antiviral Agents administration & dosage, Diagnosis, Differential, Facial Dermatoses drug therapy, Facial Dermatoses pathology, Female, Folliculitis drug therapy, Folliculitis pathology, Herpes Simplex drug therapy, Herpes Simplex pathology, Humans, Middle Aged, Valacyclovir, Valine administration & dosage, Acne Vulgaris diagnosis, Acyclovir analogs & derivatives, Facial Dermatoses diagnosis, Folliculitis diagnosis, Herpes Simplex diagnosis, Valine analogs & derivatives
- Published
- 2001
26. Granulomatous cheilitis and Borrelia burgdorferi: polymerase chain reaction and serologic studies in a retrospective case series of 12 patients.
- Author
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Muellegger RR, Weger W, Zoechling N, Kaddu S, Soyer HP, El Shabrawi-Caelen L, and Kerl H
- Subjects
- Adult, Aged, Borrelia burgdorferi Group genetics, Borrelia burgdorferi Group immunology, DNA, Bacterial blood, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin G immunology, Immunoglobulin M immunology, Male, Melkersson-Rosenthal Syndrome pathology, Middle Aged, Polymerase Chain Reaction, Retrospective Studies, Borrelia burgdorferi Group isolation & purification, Melkersson-Rosenthal Syndrome microbiology
- Abstract
Background: Granulomatous cheilitis (GC) is a chronic granulomatous inflammation of the lips of unknown etiology, which may be associated with peripheral facial nerve paralysis and/or lingua plicata (Melkersson-Rosenthal syndrome [MRS]). Borrelia burgdorferi is a spirochete that causes Lyme borreliosis, a multisystemic infectious disease with frequent occurrence of facial nerve paralysis. An etiologic role of B burgdorferi in various granulomatous diseases has been suggested. The present study was performed to examine a possible causative role of B burgdorferi for GC/MRS by B burgdorferi-specific polymerase chain reaction analysis of biopsy specimens from affected lip tissue and determination of B burgdorferi IgG and IgM serum antibodies using enzyme-linked immunosorbent assay and immunoblot tests., Observations: We examined a retrospective case series of 12 patients with GC/MRS from a Lyme borreliosis endemic area (median duration of disease, 8 months [range, 3-348 months]). Borrelia burgdorferi-specific DNA could not be amplified by polymerase chain reaction in any of the 12 patients. One (13%) of 8 patients tested had a serum B burgdorferi IgG response on enzyme-linked immunosorbent assay, and 2 patients (25%) had an IgM response, but immunoblot testing yielded negative results in all 8 patients., Conclusion: The results of the present study do not indicate that B burgdorferi has an etiologic role in GC/MRS.
- Published
- 2000
- Full Text
- View/download PDF
27. Should dermatologists go public? A skin cancer screening campaign at recreation centers.
- Author
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Hofmann-Wellenhof R, Soyer HP, Richtig E, Wolf IH, Smolle J, Scherer C, and Kerl H
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Mass Screening, Skin Neoplasms diagnosis
- Published
- 2000
- Full Text
- View/download PDF
28. Face-to-face diagnosis vs telediagnosis of pigmented skin tumors: a teledermoscopic study.
- Author
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Piccolo D, Smolle J, Wolf IH, Peris K, Hofmann-Wellenhof R, Dell'Eva G, Burroni M, Chimenti S, Kerl H, and Soyer HP
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Diagnosis, Differential, Female, Humans, Male, Melanoma pathology, Middle Aged, Nevus, Pigmented pathology, Patient Care Team, Sensitivity and Specificity, Skin pathology, Skin Neoplasms pathology, Endoscopes, Image Processing, Computer-Assisted instrumentation, Melanoma diagnosis, Nevus, Pigmented diagnosis, Remote Consultation, Skin Neoplasms diagnosis, Video Recording instrumentation
- Abstract
Background: Teledermoscopy uses telecommunication technologies to transfer images of pigmented skin lesions, including clinical and anamnestic data, via e-mail to specialized centers for teleconsultation., Design: Sixty-six pigmented skin lesions examined on a face-to-face basis in a skin lesion clinic in L'Aquila, Italy, were sent via e-mail on a standard-resolution color monitor for consultation at a university dermatology department in Graz, Austria., Intervention: Digital photographs of the clinical and dermoscopic images of all pigmented tumors were taken with a stereomicroscope connected to a high-resolution video camera in Truevision advanced graphic array (Targa) format file and converted successively into a Joint Photographic Expert Group (PEG) format file. All lesions were excised surgically and diagnosed histopathologically., Main Outcome Measure: Diagnostic concordance between face-to-face diagnosis and telediagnosis., Results: The diagnostic concordance was 60 (91%) of 66 cases. The number of correct telediagnoses was lower, but the difference was not statistically significant (Wilcoxon test, P = .10). The accuracy of the telediagnoses was not related to the quality of the images, but highly depended on the level of diagnostic difficulty of a given pigmented skin tumor (Spearman correlation, P= .01)., Conclusion: Teleconsultation of clinical and dermoscopic images of skin tumors via e-mail provides a similar degree of diagnostic accuracy as face-to-face diagnosis.
- Published
- 1999
- Full Text
- View/download PDF
29. Oral psoralen-UV-A for systemic scleroderma.
- Author
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Hofer A and Soyer HP
- Subjects
- Administration, Oral, Adult, Aged, Female, Humans, Middle Aged, Ficusin administration & dosage, PUVA Therapy, Photosensitizing Agents administration & dosage, Scleroderma, Systemic drug therapy
- Published
- 1999
- Full Text
- View/download PDF
30. Long-term follow-up and histological changes of superficial nonmelanoma skin cancers treated with topical delta-aminolevulinic acid photodynamic therapy.
- Author
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Fink-Puches R, Soyer HP, Hofer A, Kerl H, and Wolf P
- Subjects
- Administration, Topical, Aged, Aged, 80 and over, Aminolevulinic Acid administration & dosage, Aminolevulinic Acid adverse effects, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell pathology, Dermatitis, Phototoxic etiology, Female, Fluorescence, Follow-Up Studies, Humans, Male, Melanoma drug therapy, Melanoma pathology, Middle Aged, Photosensitizing Agents administration & dosage, Photosensitizing Agents adverse effects, Photosensitizing Agents therapeutic use, Retrospective Studies, Skin drug effects, Skin pathology, Skin Neoplasms pathology, Time Factors, Aminolevulinic Acid therapeutic use, Carcinoma, Basal Cell drug therapy, Carcinoma, Squamous Cell drug therapy, Photochemotherapy adverse effects, Skin Neoplasms drug therapy
- Abstract
Objective: To investigate the immediate and long-term effects of photodynamic therapy with delta-aminolevulinic acid (ALA-PDT) on superficial basal cell carcinomas (BCC) and superficial squamous cell carcinomas (SCC)., Design: Retrospective study with 60 months of maximal follow-up., Setting: University-based hospital in Graz, Austria., Patients: Forty-seven subjects with a total of 95 superficial BCC and 35 superficial SCC., Interventions: A compound of 20% delta-aminolevulinic acid was topically applied under an occlusive and light-shielding dressing before exposure to either UV-A or different wave bands of polychromatic visible light (full-spectrum visible light, >515, >570, or >610 nm)., Main Outcome Measures: Primary tumor responses and recurrence rates in the long-term follow-up, as well as histological changes associated with ALA-PDT, were studied., Results: The complete primary response rate for all wave bands of light was 86% (82/95) for superficial BCC and 54% (19/35) for superficial SCC. There was no statistically significant difference among the response rates to the different wave bands of light. After a median follow-up of 19 months (range, 3-60 months) for BCC and 8 months (range, 3-47 months) for SCC, the overall recurrence rate was 44% (36/81) and 69% (11/16), respectively. At 36 months after therapy, the projected disease-free rate was 50% (95% confidence interval, 43%-57%) for BCC vs 8% (95% confidence interval, 7%-9%) for SCC (P<.001, log-rank test). Histopathologic studies revealed a significant increase of fibrosis in the dermis after ALA-PDT and appearance of a sharp border between fibrotic and nonfibrotic tissue. In 15 of 16 BCC examined, the border between fibrotic and nonfibrotic tissue was deeper in the dermis than the maximum tumor thickness before therapy (P<.001, Wilcoxon signed rank test). Similar histopathologic observations were made in SCC., Conclusions: Our study revealed poor long-term cure rates for superficial BCC and SCC treated with topical ALA-PDT and visible light. The histopathologic observations showing remarkable fibrosis in the dermis indicated that the effect of ALA-PDT reached deeper than the initial depth of invasiveness of the neoplastic tissue, suggesting in turn that the poor long-term results of ALA-PDT cannot be explained by insufficient penetration of the therapy effect.
- Published
- 1998
- Full Text
- View/download PDF
31. Ultraviolet radiation of melanocytic nevi: a dermoscopic study.
- Author
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Hofmann-Wellenhof R, Soyer HP, Wolf IH, Smolle J, Reischle S, Rieger E, Kenet RO, Wolf P, and Kerl H
- Subjects
- Adult, Dose-Response Relationship, Radiation, Erythema etiology, Erythema pathology, Erythema physiopathology, Humans, Male, Microscopy methods, Nevus, Pigmented physiopathology, Radiation Dosage, Radiation Protection, Skin pathology, Skin physiopathology, Skin Pigmentation physiology, Skin Pigmentation radiation effects, Time Factors, Nevus, Pigmented pathology, Skin radiation effects, Ultraviolet Rays adverse effects
- Abstract
Background: UV radiation can lead to clinical, histological, and ultrastructural changes in melanocytic nevi. In this study, we investigated whether exposure to 2 minimal erythema doses of UV radiation induces changes in the dermoscopic image of acquired melanocytic nevi., Observations: Fifteen melanocytic nevi were exposed to 2 minimal erythema doses of UV radiation. Differences in dermoscopic parameters (asymmetry, border, erythema, and telangiectasias in the nevus; pigmentation; hypopigmented areas; presence, regularity, and sharpness of pigment network; and brown-black globules) in digital dermoscopic images taken before and 3, 7, 14, and 28 days after UV irradiation were scored. Three days after UV irradiation, the borders of nevi were more faded (P<.02), the nevi were darker brown (P<.02), the hypopigmented areas were smaller (P<.02), and the pigment network structures were more faded (P<.007) and less prominent (P<.02) than before UV irradiation. Seven days after UV irradiation, pigmented globules have also grown (P<.05). After 28 days, all parameters, except hypopigmented areas, were essentially the same as before UV irradiation., Conclusion: UV irradiation of melanocytic nevi with 2 minimal erythema doses induces transient changes in their dermoscopic appearance that are sometimes suggestive of malignant melanoma.
- Published
- 1998
- Full Text
- View/download PDF
32. No detection of Borrelia burgdorferi-specific DNA in erythema migrans lesions after minocycline treatment.
- Author
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Muellegger RR, Zoechling N, Soyer HP, Hoedl S, Wienecke R, Volkenandt M, and Kerl H
- Subjects
- Adult, Aged, Antibodies, Bacterial analysis, Borrelia burgdorferi Group immunology, Erythema Chronicum Migrans immunology, Female, Humans, Immunoglobulin G analysis, Immunoglobulin M analysis, Male, Middle Aged, Minocycline adverse effects, Polymerase Chain Reaction, Skin drug effects, Skin microbiology, Time Factors, Borrelia burgdorferi Group genetics, DNA, Bacterial analysis, Erythema Chronicum Migrans drug therapy, Erythema Chronicum Migrans microbiology, Minocycline therapeutic use
- Abstract
Background and Design: Early treatment of erythema migrans is important to prevent late complications. Minocycline possesses several attributes, making it potentially useful in the treatment of borrelial infections. In our study, minocycline was administered to 14 patients with erythema migrans. Punch biopsy specimens were obtained from the (affected) skin of all patients before and after therapy. The formalin-fixed, paraffin-embedded specimens were analyzed by polymerase chain reaction for the presence of Borrelia burgdorferi-specific DNA., Results: Polymerase chain reaction assay succeeded in amplifying B burgdorferi-specific DNA from the first biopsy specimen, obtained from the border of erythema migrans before initiating treatment, in eight (57%) of 14 patients. At the end of minocycline therapy, however, polymerase chain reaction analysis disclosed no B burgdorferi-specific DNA in any of the 14 patients. The good clinical response of our patients with erythema migrans substantiates our molecular findings., Conclusions: The presented polymerase chain reaction data, together with the clinical outcome, indicate that minocycline may be useful for treatment of early Lyme borreliosis.
- Published
- 1995
33. Widespread cutaneous necrosis in a patient with rheumatoid arthritis associated with anticardiolipin antibodies.
- Author
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Wolf P, Soyer HP, Auer-Grumbach P, and Kerl H
- Subjects
- Aged, Arthritis, Rheumatoid blood, Cardiolipins, Female, Humans, Necrosis, Skin Diseases complications, Antiphospholipid Syndrome complications, Arthritis, Rheumatoid complications, Skin Diseases pathology
- Published
- 1991
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