Lipschützin haavauma vulvassa nuorilla naisilla

English summary• Lipschützin haa­vauma on mel­ko harvi­nainen reaktii­vinen vul­van haa­vauma, jo­ka esiintyy nuo­rilla, usein ­sek­suaa­li­sesti koke­mat­to­milla ty­töillä. • Haa­vauman ylei­sim­pänä laukai­se­vana teki­jänä pi­detään mono­nuk­leoosia. • Muu­tos on hyvän­laa­tuinen ja pa­ranee it­sestään. Se tu­lee tun­nistaa ai­nakin pe­diatrin, gyne­ko­login ja derma­to­login vastaa­no­toilla, jot­ta väl­tytään tur­hilta, usein inva­sii­vi­silta tutki­muk­silta ja hoitoy­ri­tyk­siltä se­kä po­tilaan ja van­hempien ahdis­tuk­selta. • Diag­noosi teh­dään yleensä klii­nisen ku­van perus­teella, ja hoi­to on oireen­mu­kainen. • Ky­seessä ei ole seksi­teitse tart­tuva tau­ti

Melanoma on Tattoos : Two Finnish Cases

Peer reviewe

Kalsifylaksian onnistunut hoito moniammatillisen tiimin kuvaamana

Vertaisarvioitu.Kuvaamme erittäin laaja-alaiseen kalsifylaksiaan sairastuneen potilaan, jonka hoitotulos voitiin vuoden hoitojakson jälkeen kuitenkin katsoa onnistuneeksi. Kalsifylaksia on harvinainen ja huonoennusteinen yleissairaus. Tyypilliseen tapaan potilaammekin oikean diagnoosin varmistaminen oli vaativaa ja vei aikaa. Hoidossa onnistumisessa korostui uskallus luottaa kliiniseen arvioon ja löydöksiin, jotta tehokkaan hoidon aloitus ei tarpeettomasti viivästynyt. Hoidossa tarvittiin useiden eri erikoisalojen erityisosaamista. Moniammatillisen haavatiimin toiminta oli tehokasta ja häivytti klinikoiden välisiä raja-aitoja

Biological and clinical significance of tryptophan-catabolizing enzymes in cutaneous T-cell lymphomas

Indoleamine 2,3-deoxygenase 1 (IDO1) induces immune tolerance in the tumor microenvironment (TME) and is recognized as a potential therapeutic target. We studied the expression of both IDO1 and the related tryptophan 2,3-dioxygenase (TDO) in several different subtypes of cutaneous T-cell lymphoma (CTCL), and evaluated the kynurenine (KYN) pathway in the local TME and in patient sera. Specimens from the total of 90 CTCL patients, including mycosis fungoides (MF, n = 37), lymphomatoid papulosis (LyP, n = 36), primary cutaneous anaplastic large cell lymphoma (pcALCL, n = 4), subcutaneous panniculitis-like T-cell lymphoma (SPTCL n = 13), and 10 patients with inflammatory lichen ruber planus (LRP), were analyzed by immunohistochemistry (IHC), immunofluorescence (IF), quantitative PCR, and/or liquid chromatography-tandem mass spectrometry (LC-MS/MS). Three CTCL cell lines also were studied. Expression of both IDO1 and TDO was upregulated in CTCL. In MF specimens and in the MF cell line MyLa2000, IDO1 expression exceeded that of TDO, whereas the opposite was true for LyP, ALCL, and corresponding Mac1/2A cell lines. The spectrum of IDO1-expressing cell types differed among CTCL subtypes and was reflected in the clinical behavior. In MF, SPTCL, and LyP, IDO1 was expressed by malignant cells and by CD33(+) myeloid-derived suppressor cells, whereas in SPTCL CD163(+) tumor-associated macrophages also expressed IDO1. Significantly elevated serum KYN/Trp ratios were found in patients with advanced stages of MF. Epacadostat, an IDO1 inhibitor, induced a clear decrease in KYN concentration in cell culture. These results show the importance of IDO1/TDO-induced immunosuppression in CTCL and emphasize its role as a new therapeutic target.Peer reviewe

Mohs- eli marginaalikontrolloitu kirurgia vaikeiden tyvisolusyöpien hoidossa

English summaryPeer reviewe

Differentiating Malignant from Benign Pigmented or Non-Pigmented Skin Tumours—A Pilot Study on 3D Hyperspectral Imaging of Complex Skin Surfaces and Convolutional Neural Networks

Several optical imaging techniques have been developed to ease the burden of skin cancer disease on our health care system. Hyperspectral images can be used to identify biological tissues by their diffuse reflected spectra. In this second part of a three-phase pilot study, we used a novel hand-held SICSURFIS Spectral Imager with an adaptable field of view and target-wise selectable wavelength channels to provide detailed spectral and spatial data for lesions on complex surfaces. The hyperspectral images (33 wavelengths, 477–891 nm) provided photometric data through individually controlled illumination modules, enabling convolutional networks to utilise spectral, spatial, and skin-surface models for the analyses. In total, 42 lesions were studied: 7 melanomas, 13 pigmented and 7 intradermal nevi, 10 basal cell carcinomas, and 5 squamous cell carcinomas. All lesions were excised for histological analyses. A pixel-wise analysis provided map-like images and classified pigmented lesions with a sensitivity of 87% and a specificity of 93%, and 79% and 91%, respectively, for non-pigmented lesions. A majority voting analysis, which provided the most probable lesion diagnosis, diagnosed 41 of 42 lesions correctly. This pilot study indicates that our non-invasive hyperspectral imaging system, which involves shape and depth data analysed by convolutional neural networks, is feasible for differentiating between malignant and benign pigmented and non-pigmented skin tumours, even on complex skin surfaces

Delineating Margins of Lentigo Maligna Using a Hyperspectral Imaging System

Lentigo maligna (LM) is an in situ form of melanoma which can progress into invasive lentigo maligna melanoma (LMM). Variations in the pigmentation and thus visibility of the tumour make assessment of lesion borders challenging. We tested hyperspectral imaging system (HIS) in in vivo preoperative delineation of LM and LMM margins. We compared lesion margins delineated by HIS with those estimated clinically, and confirmed histologically. A total of 14 LMs and 5 LIVIMs in 19 patients were included. HIS analysis matched the histopathological analysis in 18/19 (94.7%) cases while in 1/19 (5.3%) cases HIS showed lesion extension not confirmed by histopathology (false positives). Compared to clinical examination, HIS defined lesion borders more accurately in 10/19 (52.6%) of cases (wider, n=7 or smaller, n=3) while in 8/19 (42.1%) cases lesion borders were the same as delineated clinically as confirmed histologically. Thus, HIS is useful for the detection of subclinical LM/LMM borders.Peer reviewe

Differentiating Malignant from Benign Pigmented or Non-Pigmented Skin Tumours—A Pilot Study on 3D Hyperspectral Imaging of Complex Skin Surfaces and Convolutional Neural Networks

Several optical imaging techniques have been developed to ease the burden of skin cancer disease on our health care system. Hyperspectral images can be used to identify biological tissues by their diffuse reflected spectra. In this second part of a three-phase pilot study, we used a novel hand-held SICSURFIS Spectral Imager with an adaptable field of view and target-wise selectable wavelength channels to provide detailed spectral and spatial data for lesions on complex surfaces. The hyperspectral images (33 wavelengths, 477–891 nm) provided photometric data through individually controlled illumination modules, enabling convolutional networks to utilise spectral, spatial, and skin-surface models for the analyses. In total, 42 lesions were studied: 7 melanomas, 13 pigmented and 7 intradermal nevi, 10 basal cell carcinomas, and 5 squamous cell carcinomas. All lesions were excised for histological analyses. A pixel-wise analysis provided map-like images and classified pigmented lesions with a sensitivity of 87% and a specificity of 93%, and 79% and 91%, respectively, for non-pigmented lesions. A majority voting analysis, which provided the most probable lesion diagnosis, diagnosed 41 of 42 lesions correctly. This pilot study indicates that our non-invasive hyperspectral imaging system, which involves shape and depth data analysed by convolutional neural networks, is feasible for differentiating between malignant and benign pigmented and non-pigmented skin tumours, even on complex skin surfaces

Molecular characterization of subcutaneous panniculitis-like T-cell lymphoma reveals upregulation of immunosuppression- and autoimmunity-associated genes

Peer reviewe

CCHCR1 Is Up-Regulated in Skin Cancer and Associated with EGFR Expression

Peer reviewe