N. C. Douglas

Strategies for assessing the degree of photodamage to skin: a systematic review of the literature

As our understanding of the role of ultraviolet (UV) radiation exposure in causing skin cancer continues to be enhanced, it is important that clinicians and researchers are familiar with the various methods for assessing photodamage to skin. This paper provides a systematic review of the published literature on invasive and noninvasive methods used to quantify lifetime UV exposure (‘photoageing’). Clinical examination, histopathology, immunohistochemistry, skin surface topography and ultrasound, in addition to newer technologies such as reflectance confocal microscopy, optical coherence tomography and multiphoton tomography, are reviewed. It is concluded that histopathological solar elastosis alone should not be viewed as a ‘gold standard’ diagnostic test and that there is no single method available to give accurate quantification of the degenerative changes associated with photodamage. Although additional research into sensitivity and specificity is still needed, skin surface topography currently has the most support in the literature as a valid and reliable noninvasive tool for the assessment of photoageing.

Effectiveness and limitations of reflectance confocal microscopy in detecting persistence of basal cell carcinomas: a preliminary study.

Background/Objectives:  Reflectance confocal microscopy (RCM) can accurately and non‐invasively diagnose basal cell carcinoma (BCC). The use of RCM in assessing responses to saucerization or curettage and cautery of BCC has not been established. The aim of the present study was to expound the usefulness of RCM in assessing treatment responses of BCC to saucerization or curettage and cautery 8–12 weeks after treatment.

Dermoscopic naevus patterns in people at high versus moderate/low melanoma risk in Queensland.

Introduction:  Dermoscopic understanding of naevus characteristics is essential baseline knowledge for identifying early malignant changes.

Quantifying the Orientation of Acquired Melanocytic Nevi on the Back

Acquired melanocytic nevi are a well-known risk factor in the development of melanoma; their increased frequency is associated with increased risk. Many recent studies have focused on the dermoscopic diagnosis of melanoma in addition to investigation of nevogenesis.1,2 However, the clinical appearance of nevus orientation has not been a target of investigation. Although not aiming to identify new phenomena, we attempt herein to quantify and explain the orientation patterns of acquired melanocytic nevi on the back. Blaschko lines are a well-described pattern of skin lines that correlates with epidermal nevi and may relate to acquired melanocytic nevus orientation.3 Quatresooz et al,4 while investigating lines of tension in skin on the back, identified a dermoscopic parallel melanotic line pattern on the normal skin of the back aligned with skin tension lines called Langer lines.4 We propose that a pattern of acquired melanocytic nevus orientation is identifiable and may be associated with both Blaschko and Langer lines.

Dermoscopic naevus patterns by age and body site in the high risk and general Queensland populations

Indigenous Australians suffer increased rates of morbidity across a wide range of medical conditions including many skin conditions. This review assesses the scope of the literature on Indigenous Dermatology. It seeks to highlight what is known about the burden of skin disease in the Indigenous population and to identify areas of uncertainty. A systematic review of research relating to Indigenous Dermatology since 1980 was performed utilizing the databases Ovid Medline, Embase, the Cochrane Library, CINAHL, Australian Institute of Aboriginal and Torres Strait Islander Studies and Australian Indigenous HealthInfoNet. This review provides an overview of what is known about Indigenous dermatology, highlights areas of clinical need and provides direction on areas requiring further research.