Nondermatoscopic Digital Imaging of Pigmented Lesions

Background/aims: Pigmented lesions are often difficult to evaluate clinically. Improvement of diagnostic accuracy by dermatoscopy has attracted much interet. With advanced digital imaging measurement of assymmetry, border irregularity and relative color as well as texture characteristics, lesional depth and changes in lesional area are now possible, the object of this review is to conclude the present status of these techniques and their potential. Conclusions: Digital imaging of pigmented lesions to this date include acquiring and storing of images, quantification of clinical features including asymmetry, and teledermatology with transfer of images. Predicted uses include malignancy evaluation, delineation of depth of invasion and the development of large collections of pigment lesions observations. The field is rapidly expanding. As of 1994, it is unknown what role digital imaging will ultimately play in clinical dermatology

Is serum TSH a biomarker of thyroid carcinoma in patients residing in a mildly iodine-deficient area?

PURPOSE: To investigate the association between the pre-operative serum TSH (s-TSH) level and differentiated thyroid carcinoma (DTC) in a mildly iodine-deficient area.METHODS: Patients undergoing surgery for thyroid nodular disease (TND) were included from three tertiary surgical departments. Data were collected from a national thyroid surgery database (THYKIR) and from patient charts. Individuals with overtly coexisting thyroid disorders were excluded for subgroup analyses. Patients were compared with the Danish background population, employing previous data from DanThyr, a study initiated to monitor the iodine fortification program in Denmark.RESULTS: Nine-hundred ninety-eight patients [cases/controls: 265/733; female/male: 794/204; age (mean ± SD): 51 ± 15 years] were included. S-TSH was significantly higher in the DTC group [median (IQR): 1.3 (0.9-1.9 mIU/L)] compared with the benign TND group [0.9 (0.6-1.5 mIU/L)] (p &lt; 0.0001). The median s-TSH in the background population was similar to that found among DTC patients (p = 1.00), but markedly higher than the s-TSH level in the benign TND group (p &lt; 0.0001). There was no association between s-TSH and DTC disease stage (p = 0.08-0.87).CONCLUSIONS: s-TSH was significantly higher in patients with DTC than in those with benign TND. However, this difference can be explained by abnormally lower s-TSH level in the latter group, probably caused by subtle nodular functional autonomy. Due to the huge overlap and the small difference in median s-TSH between patients with benign and malignant TND, s-TSH is not suitable as a biomarker of DTC in a clinical setting.</p