Bahar Dasgeb

Using noninvasive multispectral imaging to quantitatively assess tissue vasculature

This research describes a noninvasive, noncontact method used to quantitatively analyze the functional characteristics of tissue. Multispectral images collected at several near-infrared wavelengths are input into a mathematical optical skin model that considers the contributions from different analytes in the epidermis and dermis skin layers. Through a reconstruction algorithm, we can quantify the percent of blood in a given area of tissue and the fraction of that blood that is oxygenated. Imaging normal tissue confirms previously reported values for the percent of blood in tissue and the percent of blood that is oxygenated in tissue and surrounding vasculature, for the normal state and when ischemia is induced. This methodology has been applied to assess vascular Kaposis sarcoma lesions and the surrounding tissue before and during experimental therapies. The multispectral imaging technique has been combined with laser Doppler imaging to gain additional information. Results indicate that these techniques are able to provide quantitative and functional information about tissue changes during experimental drug therapy and investigate progression of disease before changes are visibly apparent, suggesting a potential for them to be used as complementary imaging techniques to clinical assessment.

The current status of bone scintigraphy in malignant diseases.

For the past few decades, planar bone scintigraphy has been the most frequently performed imaging study in the evaluation of metastatic bone disease. Although scintigraphic findings alone are often nonspecific for skeletal pathologies, this technique reportedly has an exquisite sensitivity. However, recently accumulated data on the efficacy of positron emission tomography with fluorine-18 fluorodeoxyglucose and fluorine-18 sodium fluoride as well as magnetic resonance imaging for evaluating skeletal metastatic disease now indicate that conventional planar bone scintigraphy is not very sensitive in the detection of metastatic bone lesions in selected malignancies. Nevertheless, bone scintigraphy still remains the primary imaging modality for evaluation of metastatic bone disease owing mainly to its cost effectiveness and wide availability. In addition, recently introduced hybrid imaging systems combining single-photon emission computed tomography and spiral computed tomography, although not widely available yet, increase considerably both the sensitivity and specificity of bone scintigraphy. This article focuses primarily on the current role of bone scintigraphy and its strengths and weaknesses in assessing different types of malignant diseases relative to other imaging modalities in selected malignancies.

Biopsies of Nevi in Children and Adolescents in the United States, 2009 Through 2013

Biopsies of Nevi in Children and Adolescents in the United States, 2009 Through 2013 The increase in incidence and mortality of melanoma over the past 30 years has heightened public and physician awareness. It is suggested that the combination of increasing detection pressure and poor specificity of current diagnostic strategies is driving biopsy rates to alarming levels in younger individuals despite a low risk of melanoma.1 Nevertheless, the number of nevi biopsied in children and adolescents remains poorly characterized in the United States.

Use of Ber-EP4 and Epithelial Specific Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma

EpCam is a transmembrane epithelial adhesion molecule present on all non-squamous epithelial cells. It is often overexpressed in certain carcinomas, such as breast and colon, and in dermatology, eg, basal cell carcinoma (BCC). Various monoclonal antibodies have been used to detect EpCam, including BerEP4 and epithelial specific antigen. We compared anti-EpCam clones, BerEP4, and epithelial specific antigen clone VU-1D9. One hundred and twelve lesions were stained with both antibodies. All basal cell carcinomas stained uniformly and strongly positive with both antibodies. Diffuse positive staining was also seen in all trichoepitheliomas and merkel cell carcinomas. Focal positive staining was seen in squamous cell carcinoma and benign sebaceous neoplasms. Clone VU-1D9 was more likely to produce focal positive staining as compared to BerEP4. This focal positive staining of sebaceous neoplasms and squamous cell carcinomas is a potential diagnostic pitfall.

An introduction to primary skin imaging.

Dermatology is a field in which clinical examination is heavily relied upon for diagnosis. When required, a tissue biopsy may also be performed to confirm the diagnosis. Recent advances in imaging techniques have been applied to cutaneous lesions to improve diagnostic accuracy without the need for biopsy. These new imaging techniques are reviewed for their developing role in dermatology.

A case report of Gianotti-Crosti post vaccination with MMR and dTaP.

A previously healthy 15-month-old male child presented with a monomorphic papular rash that persisted for 10 days. The rash began two days after vaccination with both measles-mumps-rubella (MMR) and diphtheriatetanus-acellular pertussis (DTaP), first appearing on his thighs and then extending to his arms, legs, and face (Fig. 1). It was nonpruritic in nature and not associated with fever, any constitutional symptoms, or recent illness. There was no involvement of mucosal membranes. He was not on any medication, did not have any medical condition, and met all of his developmental milestones. His immunizations were up-to-date and without previous adverse reactions. He had no family history of atopy. On physical examination, there were erythematous papules that were symmetric and measured 1–4 mm (Fig. 2). They were present on his cheeks, arms, and legs in an acral distribution. The papules coalesced to form plaques and were without scale or desquamation. There was notable sparing of his chest, abdomen, back, and buttocks. He was otherwise well and did not have lymphadenopathy or hepatosplenomegaly. A clinical diagnosis of Gianotti-Crosti syndrome was made, and no further workup was pursued. Discussion

Using Quantitative Imaging Techniques to Assess Vascularity in AIDS-Related Kaposi's Sarcoma

Three quantitative and non-invasive techniques were used to monitor angiogenesis in Kaposis sarcoma patients: thermography, laser Doppler imaging (LDI), and near-infrared spectroscopy. Before and after combination cytotoxic and anti-angiogenesis therapy, blood volume, oxygenated hemoglobin, temperature, and blood flow were analyzed. These three techniques are objective, easy to perform, and appear to be very sensitive in assessing changes in the lesions upon administration of therapy

Colchicine: an ancient drug with novel applications

Colchicine is a treatment for gout that has been used for more than a millennium. It is the treatment of choice for familial Mediterranean fever and its associated complication, amyloidosis. The 2009 U.S. Food and Drug Administration approval of colchicine as a new drug had research consequences. Recent investigations with large cohorts of patients with gout who have been taking colchicine for years have demonstrated novel applications within oncology, immunology, cardiology and dermatology. Some emerging dermatological uses include the treatment of epidermolysis bullosa acquisita, leucocytoclastic vasculitis, aphthous stomatitis and others. In this work we relate the history and the new horizon of this ancient medicine.

Cutaneous Crohn's disease with superimposed psoriasis: A unique case with overlapping histology

Crohns disease (CD) is an idiopathic, chronic inflammatory disorder of the gastrointestinal tract. We recently encountered a unique case in which a patient with longstanding CD presented with skin lesions with histopathologic features of both psoriasis and granulomatous inflammation suggestive of cutaneous CD. To our knowledge, this has not been described concomitantly in the same patient, in the same lesions. Review of the literature suggests that the intersection of these 2 histopathological reaction patterns may not be pure coincidence. Clinical‐pathologic correlation of this case will be discussed, along with a review of the potential mechanisms of this unique disease presentation.

Feature analysis of ultrasound elastography image for quantitative assessment of cutaneous carcinoma

To evaluate the feasibility of using quantitative texture features computed from high frequency ultrasound and ultrasound elastography (USE) images in the discrimination of benign from malignant skin lesions.