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Cold atmospheric plasma (CAP) has been shown to be beneficial in various medical fields such as wound healing, oncology or dentistry. A prominent effect induced by CAP is the boost of microcirculation in human skin tissue. Being a complex cocktail of physical and chemically reactive components, the mechanisms by which CAP enhances microcirculation still remain unclear. Thus, this study aims to identify relevant CAP components involved in stimulation of dermal microcirculation. In a comparative approach, the application of the same CAP source was modified in such a way that three different treatment modalities could be realized, each with a characteristic composition of electrical current flow and concentration of reactive species. Microcirculation parameters oxygen saturation (StO2), tissue hemoglobin index, near-infrared perfusion index and tissue water index were recorded before and after each treatment on the lateral proximal left arm of 10 healthy volunteers by means of hyperspectral imaging. The maximum microcirculatory response to CAP was observed when all components were allowed to interact with skin tissue (standard treatment). In contrast, no upregulation was found as soon as electric currents and fields had been removed from the effective component spectrum. Application of the CAP source at reduced concentrations of reactive species compared to standard treatment led to significant but less pronounced enhancement of dermal microcirculation. The findings of this study indicate that a synergistic interplay of all CAP components promotes microcirculation in dermal tissue most effectively. Moreover, the findings support the hypothesis that electric currents and fields play a key role in enabling microcirculation boost whereas availability of reactive species in the gas phase is associated with the intensity of the tissue response to CAP treatment. [ABSTRACT FROM AUTHOR]

Summary: Background: Follow‐up protocols in patients after complete resection of high‐risk cutaneous tumors lead to a discovery of metastases in very early stages, but surgery on non‐palpable lesions proves to be challenging. Patients and methods: In this monocenter retrospective study 39 patients suffering from malignant skin tumors with suspicious non‐palpable lesions located in the lymph nodes (90%) or deep subcutaneously/intramuscularly (10%) were included. In 21 patients the lesions were excised under ultrasound guidance, and 18 patients received a wire marking before surgery. Both patient groups were compared regarding successful intraoperative finding of the lesion, duration of the procedure, and complications. Results: Wire marking led to a significantly higher intraoperative detection rate of 100% versus 76% (p < 0.05). The average time needed for the complete procedure (p = 0.91) or the rate of complications (p = 0.70) did not differ significantly between both groups. The size of the malignant lesions successfully removed by wire marking was significantly smaller (p < 0.05). Of all 34 detected lesions only 20 (58.8%) were confirmed to be malignant. Conclusions: Wire marking increases the detection rate of non‐palpable suspicious subcutaneous or lymphatic lesions. It leads to earlier diagnosis of metastasis but also allows to avoid unnecessary complete lymph node dissection. [ABSTRACT FROM AUTHOR]

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Cutaneous melanoma is the most lethal skin cancer and noninvasively distinguishing it from benign tumor is a major challenge. Raman spectroscopic measurements were conducted on 65 suspected melanocytic lesions and surrounding healthy skin from 47 patients. Compared to the spectra of healthy skin, spectra of melanocytic lesions exhibited lower intensities in carotenoid bands and higher intensities in lipid and melanin bands, suggesting similar variations in the content of these components. Distinct variations were observed among the autofluorescence intensities of healthy skin, benign nevi and malignant melanoma. By incorporating autofluorescence information, the classification accuracy of the support vector machine for spectra of healthy skin, nevi, and melanoma reached 90.2%, surpassing the 87.9% accuracy achieved without autofluorescence, with this difference being statistically significant. These findings indicate the diagnostic value of autofluorescence intensity, which reflect differences in fluorophore content, chemical composition, and structure among healthy skin, nevi, and melanoma. [ABSTRACT FROM AUTHOR]

Background: Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative. Methods: In this monocentric pilot study, 19 patients suffering from NMSC were treated with RSCT. Most of these patients had also experienced surgery, either because they developed a new NMSC in aftercare, or they had suffered previously from NMSC. Three RSCT-treated patients, who had no exposure to surgery so far, were paired with three matched patients, who had received surgery. We sought to evaluate and compare the patients' experience with both treatments. A questionnaire assessed patients' perceptions regarding side effects, aesthetic outcomes, wound care, fear of complications, and personal treatment preferences. Patients evaluated the different parameters of their either RSCT- or surgery-treated lesions on a scale from 0–10. Results: Patients were more afraid of complications before surgery than before RSCT (p = 0.04). Treatment with RSCT caused significantly less pain on treatment day (mean 0.56) than surgery (mean 2.32) (0 no pain, 10 maximum pain) (p = 0.02) and 14 days after the procedure (mean 0.89 versus mean 2.47) (p = 0.02). On day 14, RSCT-treated lesions were also significantly less itchy (mean 0.34) than after surgery (mean 1.50). Most patients were very satisfied with the aesthetic outcome after both RSCT (mean 8.42) and surgery (mean 8.31) (p = 0.89). In the case of a new NMSC, the majority of patients who experienced both treatments would rather be treated primarily with RSCT (44%) or would consider both options (31%); only 19% preferred surgery. Conclusion: Patients evaluated RSCT as less painful than surgery. The aesthetic outcomes of both treatments were comparable. For pain-sensitive patients, RSCT might be a preferable treatment option. [ABSTRACT FROM AUTHOR]

The purpose of this study is to develop a method to discriminate spectral signatures in wound tissue. We have collected a training set of the intensity of the remitted light for different types of wound tissue from different patients using a TIVITA™ tissue camera. We used a neural network technique (self-organizing map) to group areas with the same spectral properties together. The results of this work indicates that neural network models are capable of finding clusters of closely related hyperspectral signatures in wound tissue, and thus can be used as a powerful tool to reach the anticipated classification. Moreover, we used a least square method to fit literature spectra (i.e. oxygenated haemoglobin (O2Hb), deoxygenated haemoglobin (HHb), water and fat) to the learned spectral classes. This procedure enables us to label each spectral class with the corresponding absorbance properties for the different absorbance of interest (i.e. O2Hb, HHb, water and fat). The calculated parameters of a testing set were consistent with the expected behaviour and show a good agreement with the results of a second algorithm which is used in the TIVITA™ tissue camera.