Skaidra Valiukevičienė

Measurement of melanoma thickness ― comparison of two methods: Ultrasound versus morphology

OBJECTIVE The aim of our study was to investigate the association between non-invasive ultrasound examination and morphologic test results in the measurement of cutaneous melanoma thickness influencing surgical treatment strategy. METHODS Our prospective clinical study has been conducted in the Clinic of Plastic and Reconstructive Surgery of Kaunas University of Medicine Hospital (KUMH) since January 2004 until October 2008. A total of 100 patients with a clear clinical diagnosis of stage I-II cutaneous melanoma were enrolled in this study. Melanoma depth was measured using a linear 14-MHz frequency ultrasound sensor (Toshiba Xario XG). Surgically removed fragments of skin-subcutaneous tissue were fixated using 10% formalin solution in the operating theatre, and sent to KUMH Clinic of Pathological Anatomy. The most informative sections were analysed for tumour thickness, according to Breslow, as well as tumour type, vascular and lymphatic invasion and dissemination. A comparative data analysis of melanoma thickness measured by ultrasound (T) preoperatively and histologically estimated cutaneous melanoma (CM) thickness according to Breslow (pT) using the Bland-Altman method was performed. RESULTS Higher mean difference of melanoma thickness (60 μm) between T and pT measurements was found when tumour thickness matched pT1 and pT2 categories. In cases of CM depth exceeding 2mm, mean difference of measurements between CM thickness determined by ultrasound and histological examination was lower (30 μm). Data regression analysis showed that correlation between T and pT measurements was lower when CM was thinner (1-2 mm) (Pearsons correlation coefficient, r: 0.283). In cases of thicker melanoma (>2 mm), strong and statistically significant (p<0.0001) correlation (r: 0.869) was observed. CONCLUSIONS Correlation between melanoma thickness measured using a linear 14-MHz frequency ultrasound sensor and histologically estimated melanoma thickness according to Breslow was lower if melanoma was thinner (1-2 mm). However, in cases of thicker melanoma (>2 mm), very strong correlation between measurements was observed.

Occupational skin diseases: actual state analysis of patient management pathways in 28 European countries

Work‐related skin diseases (WSD) are caused or worsened by a professional activity. Occupational skin diseases (OSD) need to fulfil additional legal criteria which differ from country to country. OSD range amongst the five most frequently notified occupational diseases (musculoskeletal diseases, neurologic diseases, lung diseases, diseases of the sensory organs, skin diseases) in Europe.

European Surveillance System on Contact Allergies (ESSCA) : Results with the European baseline series, 2013/14

Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, such as introduction of new substances, new products or formulations and regulatory intervention, the spectrum of contact sensitization changes.

Preoperative assessment of skin tumor thickness and structure using 14-MHz ultrasound

OBJECTIVE The aim of this study was to compare the relationship between skin tumor thickness and homogeneity and to evaluate the accuracy of 14-MHz ultrasound while measuring the thickness of different skin tumors. MATERIAL AND METHODS The ultrasonographic and histological analysis of 72 skin tumors was performed. Preoperative vertical tumor thickness (T) and structure of 12 melanomas, 34 melanocytic nevi and 26 basal cell carcinomas was assessed by 14-MHz ultrasonography. After the tumors were excised the vertical thickness measurement (Breslow index, pT) was performed by pathologist. According to the histological thickness all skin tumors were divided to thin (≤1mm) and thick (>1mm). The accuracy of the 14-MHz ultrasound measurements and correlation between the ultrasonographic and histological tumor thickness were estimated. RESULTS Homogeneous structure was assessed for all thin (≤1mm) and the majority (81.3%) of thick (>1mm) melanocytic skin tumors. Nonhomogeneous structure was estimated in thin and thick basal cell carcinomas, accordingly 42.9% and 31.9%. Measurements of T and pT correlated moderately in thick (>1mm) tumors (r=0.694), while in thin (≤1mm) tumors correlation was low (r=0.336). Moderate correlation between ultrasonographic and histological thickness was computed for melanocytic skin tumors as well as for basal cell carcinomas (r=0.564 and r=0.690). CONCLUSIONS Medium frequency ultrasound is not a reliable tool for the precise measurement of thin (≤1mm) skin tumors. Ultrasonography using a 14-MHz frequency transducer enables more precisely to measure the thickness of basal cell carcinoma than melanocytic skin tumors. The 14-MHz ultrasound is support tool to suggest the morphologic type of skin tumor.

Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma: Analysis of recurrence-free survival.

BACKGROUND AND AIM Cutaneous squamous cell carcinoma (CSCC) is a malignant epithelial cell tumor. CSCC has a tendency to spread via lymphogenic pathway. Metastases are found in 2%-6% of cases. Prognosis of patients with CSCC is directly related to the morphology and localization of primary tumor. The aim of this study was to evaluate the recurrence-free survival of patients with CSCC after tumor excision and SLNB as well as to analyze morphologic CSCC features related to patient recurrence-free survival. MATERIALS AND MATERIALS A retrospective analysis of 51 patients with CSCC, who underwent surgical treatment between January 1, 2012, and December 31, 2014, in the Clinic of Plastic and Reconstructive Surgery, Hospital of the Lithuanian University of Health Sciences, was done. The diagnosis of CSCC was verified on a histological examination, and all patients had no clinical evidence of nodal or distant metastases on a physical examination or imaging studies. Sentinel lymph node biopsy (SLNB) was performed for low- and high-risk CSCC patients. RESULTS A total of 51 patients were enrolled into the study (34 women and 17 men). Total of 68 lymph nodes were removed during sentinel lymph node biopsy. No micrometastases were identified. Until April 1, 2015, no relapse event was documented. The mean time after operation was 27.5 months. During the follow-up period, no distant metastases were identified. CONCLUSIONS No patient who had no micrometastases in sentinel lymph nodes developed local and distant CSCC metastases during the follow-up period. Our report supports the concept that SLNB can be applied for CSCC. It is obvious that larger prospective studies with longer follow-up period are needed to establish the efficacy of SLNB and define the optimal treatment of occult nodal metastasis for CSCC.

Associations of the quality of life and psychoemotional state with sociodemographic factors in patients with psoriasis

OBJECTIVE The aim of this study was to evaluate the interrelationships between the quality of life and psycho-emotional, demographic, and clinical factors in patients with psoriasis. MATERIALS AND METHODS The study included 18-year-old or older patients with psoriasis recruited from the university hospital (n=385). Their sociodemographic data, Psoriasis Area and Severity Index score and disease duration were assessed. The quality of life was evaluated by using the Dermatology Life Quality Index. Depression and anxiety were assessed using the Hospital Anxiety and Depression scale. RESULTS A severe change in the quality of life (DLQI≥10 points) was found by 1.8 times more commonly in females, by 2.7 times more commonly in patients with moderate and severe psoriasis (PASI≤10) than in those with a mild psoriasis (PASI≤10), and by about 2 times more commonly in patients with nail psoriasis than in those without, as well as in patients with psoriasis-related anxiety or depression than in subjects without those symptoms. Anxiety and depression were observed in 37.4% and 23.4% of the patients, respectively. Depression was more frequent in patients older than 55 years than in those <35 years of age. Anxiety was more frequent in females and in the respondents with primary and unfinished secondary education. CONCLUSIONS One-half of patients with psoriasis, women more often than men, regardless of the severity of the disease, reported a significant change in their quality of life. Patients with psoriasis, especially women and older people (aged more than 55 years), experienced anxiety and symptoms of depression.

European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009-2014: ESSCA polysensitization 2009-2014

Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life.

The significance of spectrophotometric image analysis for diagnosis of the melanocytic skin tumours in association with their thickness

Cutaneous melanoma is a melanocytic skin tumour, which has very poor prognosis while it is highly resistant to treatment and tends to metastasize. Thickness of melanoma is one of the most important biomarker for stage of disease, prognosis and surgery planning. In this study, we hypothesized that the analysis of spectrophotometric (SIAscope) images can provide the information about skin tumour thickness.