Low-cost, high-speed near infrared reflectance confocal microscope

We have developed a low-cost, near-infrared (NIR) reflectance confocal microscope (RCM) to overcome challenges in the imaging depth and speed found in our previously-reported smartphone confocal microscope. In the new NIR RCM device, we have used 840 nm superluminescent LED (sLED) to increase the tissue imaging depth and speed. A new confocal detection optics has been developed to maintain high lateral resolution even when a relatively large slit width was used. The material cost of the NIR RCM device was still low, similar to$5,200. The lateral resolution was 1.1 mu m and 1.3 mu m along the vertical and horizontal directions, respectively. Axial resolution was measured as 11.2 mu m. In vivo confocal images of human forearm skin obtained at the imaging speed of 203 frames/sec clearly visualized characteristic epidermal and dermal cellular features of the human skin. (C) 2019 Optical Society of America under the terms of the OSA Open Access Publishing AgreementNational Institutes of Health/Fogarty International Center [R21TW010221]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Long-Term Use of Nonsteroidal Anti-inflammatory Drugs Decreases the Risk of Cutaneous Melanoma: Results of a United States Case–Control Study

Experimental and observational studies continue to demonstrate conflicting results regarding the role of several commonly used drugs as melanoma chemopreventive agents. This case–control study was designed to assess the associations between cutaneous melanoma (CM) and exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) and statins in current users. A total of 400 CM and 600 eligible age- and gender-matched community-based controls were prospectively recruited and interviewed. We assessed participants’ demographic characteristics, CM risk factors, and current and previous use of medications. Multivariable conditional logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for associations between NSAIDs and/or aspirin (ASA), statin exposure, and CM risk. Half of the subjects were men (mean age 60 years). After adjusting for confounders, use of any type of NSAIDs for more than 5 years significantly reduced the risk of melanoma development compared with the low-exposure group (adjusted OR=0.57; 95% CI=0.43–0.77). Subgroup analyses showed that the observed risk reduction was primarily driven by continuous ASA use (>5 years adjusted OR=0.51, 95% CI=0.35–0.75). No significant protective effect was observed with statin exposure (OR=0.97, 95% CI=0.73–1.29). Long-term use of NSAIDs, especially ASA, is associated with a significantly decreased risk of CM development. Clinical intervention studies are warranted to further investigate the potential role of ASA and other NSAIDs as chemopreventive agents for CM.JID JOURNAL CLUB ARTICLE: For questions, answers, and open discussion about this article, please go to http://www.nature.com/jid/journalclu

Technique standards for skin lesion imaging: a delphi consensus statement

IMPORTANCE Variability in the metrics for image acquisition at the total body, regional, close-up, and dermoscopic levels impacts the quality and generalizability of skin images. Consensus guidelines are indicated to achieve universal imaging standards in dermatology. OBJECTIVE To achieve consensus among members of the International Skin Imaging Collaboration (ISIC) on standards for image acquisition metrics using a hybrid Delphi method. EVIDENCE REVIEW Delphi study with 5 rounds of ratings and revisions until relative consensus was achieved. The initial set of statements was developed by a core group (CG) on the basis of a literature review and clinical experience followed by 2 rounds of rating and revisions. The consensus process was validated by an extended group (EG) of ISIC members through 2 rounds of scoring and revisions. In all rounds, respondents rated the draft recommendations on a 1 (strongly agree) to 5 (strongly disagree) scale, explained ratings of less than 5, and optionally provided comments. At any stage, a recommendation was retained if both mean and median rating was 4 or higher. RESULTS The initial set of 45 items (round 1) was expanded by the CG to 56 variants in round 2, subsequently reduced to 42 items scored by the EG in round 3, yielding an EG set of 33 recommendations (rounds 4 and 5): General recommendation (1 guideline), lighting (5), background color (3), field of view (3), image orientation (8), focus/depth of field (3), resolution (4), scale (3), color calibration (2), and image storage (1). CONCLUSIONS AND RELEVANCE This iterative process of ratings and comments yielded a strong consensus on standards for skin imaging in dermatology practice. Adoption of these methods for image standardization is likely to improve clinical practice, information exchange, electronic health record documentation, harmonization of clinical studies and database development, and clinical decision support. Feasibility and validity testing under real-world clinical conditions is indicated

Proposed technical guidelines for the acquisition of clinical images of skin-related conditions

IMPORTANCE Standardizing dermatological imaging is important to improve monitoring of skin lesions and skin conditions, ensure the availability of high-quality images for teledermatology, and contribute to the development of a robust archive of skin images to be used for research

Pediatric melanoma: Analysis of an international registry

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101810/1/cncr28289.pd

Widespread Hypertrophic Lichen Planus following Programmed Cell Death Ligand 1 Blockade

Hypertrophic lichen planus (HLP) may not have the typical histological findings of lichen planus and often mimics squamous cell carcinoma (SCC). Distinguishing between the two can pose a diagnostic challenge. Here, we present a case of eruptive HLP mimicking SCC in the context of programmed cell death ligand 1 (PD-L1) immune checkpoint inhibition. A 73-year-old woman recently treated with durvalumab, an anti-PD-L1 antibody, presented to our clinic with diffuse hyperkeratotic papules and plaques previously thought to be eruptive SCC. The lesions did not respond to topical fluorouracil and continued to appear despite discontinuation of immunotherapy. Further histological analysis revealed intraepidermal epithelial proliferation with lichenoid inflammation. Subsequent treatment with topical corticosteroids significantly improved the size and number of lesions. The diagnosis of HLP was made based on histological features and response to topical steroids in the context of recent immunotherapy. This case reveals HLP as a potential adverse effect of PD-L1 inhibition and highlights the need for additional diagnostic assessment in patients presenting with eruptive hyperkeratotic lesions, especially on the lower extremities.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Preliminary imaging of skin lesions with near-infrared, portable, confocal microscopy

12 month embargo; first published online 25 December 2020This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]