Intratonsillar detection of 27 distinct viruses: A cross-sectional study

Palatine tonsils have been observed to harbor several distinct respiratory and herpesviruses in separate studies. In this study, the presence of these viruses in palatine tonsils was comprehensively studied in both children and adults. A cross-sectional analysis of 181 patients (median age 22 years; range, 2.6-66) operated for a benign tonsillar disease was conducted. Real-time polymerase chain reaction was performed to detect 27 distinct viruses in all: eight human herpesviruses, 16 respiratory viruses, parvo B19, and polyoma BK/JC viruses. Clinical characteristics of the patients and underlying conditions were evaluated. In total, 92% of patients had virus detected in tonsils (Epstein-Barr virus 72%, human herpesvirus 7, and 6B 54% and 16%, respectively, enterovirus 18%, parvovirus B19 7% and the rest <4%). No herpes simplex virus 2, varicella zoster virus, polyoma JC virus, parainfluenza-, metapneumo-, or coronaviruses were found. Enterovirus was more common in children and was frequently observed in the presence of HHV6B. None of the viruses showed a positive association to the tonsillar disease. Respiratory symptoms were not associated with the prevalence of viruses. This study comprehensively reports a cross-sectional view of intratonsillar virus infections in elective tonsillectomy patients in a wide age range cohort. Tonsils are a major virus reservoir for distinct herpes and respiratory viruses without a positive association with tonsillar disease or respiratory symptoms

Ablative fractional laser‐assisted photodynamic therapy for lentigo maligna : a prospective pilot study

Background Lentigo maligna (LM) is an in‐situ form of melanoma carrying a risk of progression to invasive lentigo maligna melanoma (LMM). LM poses a clinical challenge, with subclinical extension and high recurrence rates after incomplete surgery. Alternative treatment methods have been investigated with varying results. Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) has already proved promising in this respect. Objectives To investigate the efficacy of ablative fractional laser (AFL)‐assisted PDT with 5‐aminolaevulinic acid nanoemulsion (BF‐200 ALA) for treating LM. Methods In this non‐sponsored, prospective pilot study ten histologically verified LMs were treated with AFL‐assisted PDT three times at two week intervals using a light dose of 90 J/cm2 per treatment session. Local anaesthesia with ropivacain was used. Four weeks after the last PDT treatment the lesions were treated surgically with a wide excision and sent for histopathological examination. The primary outcome was complete histopathological clearance of the LM from the surgical specimen. Patient‐reported pain during illumination and the severity of the skin reaction after the PDT treatments were monitored as secondary outcomes. Results The complete histopathological clearance rate was 7 out of 10 LMs (70%). The pain during illumination was tolerable, with the mean pain scores for the PDT sessions on a visual assessment scale ranging from 2.9 to 3.8. Some severe skin reactions occurred during the treatment period, however. Conclusions AFL‐assisted PDT showed moderate efficacy in terms of histological clearance. It could constitute an alternative treatment for lentigo maligna but due to the side‐effects it should only be considered in inoperable cases.peerReviewe

Pityriasis lichenoides et varioliformis acuta after SARS-CoV-2 infection and relapse after vaccination

Non peer reviewe

Hyperspectral Imaging System in the Delineation of Ill-defined Basal Cell Carcinomas : A Pilot Study

Background Basal cell carcinoma (BCC) is the most common skin cancer in the Caucasian population. Eighty per cent of BCCs are located on the head and neck area. Clinically ill‐defined BCCs often represent histologically aggressive subtypes, and they can have subtle subclinical extensions leading to recurrence and the need for re‐excisions. Objectives The aim of this pilot study was to test the feasibility of a hyperspectral imaging system (HIS) in vivo in delineating the preoperatively lateral margins of ill‐defined BCCs on the head and neck area. Methods Ill‐defined BCCs were assessed clinically with a dermatoscope, photographed and imaged with HIS. This was followed by surgical procedures where the BCCs were excised at the clinical border and the marginal strip separately. HIS, with a 12‐cm2 field of view and fast data processing, records a hyperspectral graph for every pixel in the imaged area, thus creating a data cube. With automated computational modelling, the spectral data are converted into localization maps showing the tumour borders. Interpretation of these maps was compared to the histologically verified tumour borders. Results Sixteen BCCs were included. Of these cases, 10 of 16 were the aggressive subtype of BCC and 6 of 16 were nodular, superficial or a mixed type. HIS delineated the lesions more accurately in 12 of 16 of the BCCs compared to the clinical evaluation (4 of 16 wider and 8 of 16 smaller by HIS). In 2 of 16 cases, the HIS‐delineated lesion was wider without histopathological confirmation. In 2 of 16 cases, HIS did not detect the histopathologically confirmed subclinical extension. Conclusions HIS has the potential to be an easy and fast aid in the preoperative delineation of ill‐defined BCCs, but further adjustment and larger studies are warranted for an optimal outcome.peerReviewe

Hyperspectral imaging in detecting dermal invasion in lentigo maligna melanoma

nonPeerReviewe