Profiling and imaging of forensic evidence – a pan-European forensic round robin study part 1: document forgery

The forensic scenario, on which the round robin study was based, simulated a suspected intentional manipulation of a real estate rental agreement consisting of a total of three pages. The aims of this study were to (i) establish the amount and reliability of information extractable from a single type of evidence and to (ii) provide suggestions on the most suitable combination of compatible techniques for a multi-modal imaging approach to forgery detection. To address these aims, seventeen laboratories from sixteen countries were invited to answer the following tasks questions: (i) which printing technique was used? (ii) were the three pages printed with the same printer? (iii) were the three pages made from the same paper? (iv) were the three pages originally stapled? (v) were the headings and signatures written with the same ink? and (vi) were headings and signatures of the same age on all pages? The methods used were classified into the following categories: Optical spectroscopy, including multispectral imaging, smartphone mapping, UV-luminescence and LIBS; Infrared spectroscopy, including Raman and FTIR (micro-)spectroscopy; X-ray spectroscopy, including SEM-EDX, PIXE and XPS; Mass spectrometry, including ICPMS, SIMS, MALDI and LDIMS; Electrostatic imaging, as well as non-imaging methods, such as non-multimodal visual inspection, (micro-)spectroscopy, physical testing and thin layer chromatography. The performance of the techniques was evaluated as the proportion of discriminated sample pairs to all possible sample pairs. For the undiscriminated sample pairs, a distinction was made between undecidability and false positive claims. It was found that none of the methods used were able to solve all tasks completely and/or correctly and that certain methods were a priori judged unsuitable by the laboratories for some tasks. Correct results were generally achieved for the discrimination of printer toners, whereas incorrect results in the discrimination of inks. For the discrimination of paper, solid state analytical methods proved to be superior to mass spectrometric methods. None of the participating laboratories deemed addressing ink age feasible. It was concluded that correct forensic statements can only be achieved by the complementary application of different methods and that the classical approach of round robin studies to send standardised subsamples to the participants is not feasible for a true multimodal approach if the techniques are not available at one location

Solid-phase synthesis of Rhodamine-110 fluorogenic substrates and their application in forensic analysis

A novel synthesis demonstrates the rapid and efficient preparation of fluorogenic substrates containing Rhodamine-110 fluorophores for the detection of biological evidence.</p

The applicability of fluorescence lifetime to determine the time since the deposition of biological stains

This work demonstrates that fluorescence lifetime measurements can successfully predict the age of human bloodstains.</p

Clinicopathological and dermoscopic features of amelanotic and hypomelanotic melanoma: a retrospective multicentric study

Background: Amelanotic and hypomelanotic melanoma (AHM) has a higher risk of delayed diagnosis and a significant lower 5-year melanoma-specific survival compared to pigmented melanoma. Our aim was the evaluation of the clinicopathological/dermoscopic features of amelanotic melanoma (AM) and hypomelanotic melanoma (HM). Methods: All participants had a personal history of AHM. We defined HM as showing clinical/dermoscopic pigmentation in&nbsp;&lt;&nbsp;25% of the lesion\u2019s surface and histopathological focal pigmentation, while AM as melanomas with clinical/dermoscopic and histopathological absence of pigmentation. Results: The most common phenotypic traits among the 145 AHM patients were as follows: phototype II, blue-grey eyes, and dark brown hair. Red hair was present in 23.8% AHM cases (AM&nbsp;=&nbsp;22.60%; HM&nbsp;=&nbsp;25.80%). The most affected area was the back (29.5%). A total of 67.1% were classified as AM and 32.9% as HM. The most represented hair colors in AM and HM were, respectively, blonde and dark brown hair. Median Breslow thickness was 1.7 mm, superficial spreading melanoma (SSM) and nodular melanoma (NM) were the most represented histotypes, and mitotic rate &gt;&nbsp;1&nbsp; 7&nbsp;mm2 was reported in 73.3% cases, and regression was significantly more present in HM. Dermoscopy showed high prevalence of white structureless zones (63.4%), linear looped vessels (58.8%), linear irregular vessels (50.0%), and arborizing vessels (47.2%). Multivariate logistic regression confirmed the association between the presence of pigmentation and the following: histological regression, dermoscopic globules, and arborizing vessels. Conclusions: Predominance of red hair in AHM patients was not confirmed. AHM affects mostly intermittent sun-exposed body areas. The deeper median Breslow thickness (versus pigmented melanoma), the association of AM with the nodular histotype, and the high mitotic rate highlight the AHM\u2019s aggressiveness. HM\u2019s higher levels of regression can be explained by the presence of pigmentation, driving the underlying immune response. AHM showed a polymorphous vascular pattern and significant presence of arborizing vessels (especially HM)

Cutaneous squamous cell carcinoma. Italian guidelines by SIDeMaST adapted to and updating EADO/EDF/EORTC guidelines

18nonenonePeris, Ketty; Alaibac, Mauro; Argenziano, Giuseppe; Di Stefani, Alessandro; Fargnoli, Maria C; Frascione, Pasquale; Gualdi, Giulio; Longo, Caterina; Moscarella, Elvira; Naldi, Luigi; Pellacani, Giovanni; Pimpinelli, Nicola; Quaglino, Pietro; Salgarello, Marzia; Sollena, Pietro; Valentini, Vincenzo; Zalaudek, Iris; Calzavara Pinton, PPeris, Ketty; Alaibac, Mauro; Argenziano, Giuseppe; Di Stefani, Alessandro; Fargnoli, Maria C; Frascione, Pasquale; Gualdi, Giulio; Longo, Caterina; Moscarella, Elvira; Naldi, Luigi; Pellacani, Giovanni; Pimpinelli, Nicola; Quaglino, Pietro; Salgarello, Marzia; Sollena, Pietro; Valentini, Vincenzo; Zalaudek, Iris; Calzavara Pinton,

Physician-patient communication and patient-reported outcomes in the actinic keratosis treatment adherence initiative (AK-TRAIN): a multicenter, prospective, real-life study of treatment satisfaction, quality of life and adherence to topical field-directed therapy for the treatment of actinic keratosis in Italy

Background: Patients with multiple actinic keratoses (AKs) should be treated with field-directed therapy. Such treatments challenge patients’ adherence due to out-of-pocket costs, length of treatment and severity of local skin reactions (LSRs). Effective physician–patient communication (PPC) may buffer therapy-related distress, thus improving quality of life, treatment satisfaction and adherence. Objectives: We evaluated the interplay between PPC, LSR intensity (safety) and lesion clearance rates (effectiveness) on treatment satisfaction, quality of life and treatment adherence among patients with multiple AKs receiving topical field-directed therapies. Methods: In this observational, multicentre, longitudinal, cohort study, we included 1136 adult patients with discrete, clinically detectable, visible, multiple (three or more lesions in a 25 cm 2 area), Grade I/II AKs, for whom the attending dermatologist has prescribed treatment with a topical field-directed therapy. We matched self-reported data and medical information recorded by dermatologists in standard clinical forms. Patients were followed up at two time points (T1: 8 days; T2: 25–30 days). Results: Most patients were elderly, married, men with poor socio-economic status and multiple lesions of the scalp or face. The majority (n = 961) had a prescription of ingenol mebutate (IMB) and 175 received either diclofenac 3% in hyaluronic acid (DHA) or imiquimod 5% (IMQ). Clearance rate at 1 month was 84%. Most patients felt very supported (n = 819, 73%) and rated dermatologist's explanations very clear (n = 608, 54%). Treatment satisfaction (effectiveness and convenience scales) increased along the follow-up, especially for those on IMB (Δ pre-post = −4.00; other: Δ pre-post = −0.25; interaction P < 0.001). Communication clarity was associated with higher treatment satisfaction scores (β = 0.4–0.6, P < 0.01) and lower risk of non-adherence among IMB patients (risk difference: 16%, P < 0.01). Conclusion: Communication clarity was associated with patient-reported outcomes and adherence beyond AK-related clinical parameters. Our study questions the current episodic approach to AK management and provides the rationale to develop chronic care models fostering patients’ engagement and treatment alliance

Physician–patient communication and patient-reported outcomes in the actinic keratosis treatment adherence initiative (AK-TRAIN): a multicenter, prospective, real-life study of treatment satisfaction, quality of life and adherence to topical field-directed therapy for the treatment of actinic keratosis in Italy

Background: Patients with multiple actinic keratoses (AKs) should be treated with field-directed therapy. Such treatments challenge patients’ adherence due to out-of-pocket costs, length of treatment and severity of local skin reactions (LSRs). Effective physician–patient communication (PPC) may buffer therapy-related distress, thus improving quality of life, treatment satisfaction and adherence. Objectives: We evaluated the interplay between PPC, LSR intensity (safety) and lesion clearance rates (effectiveness) on treatment satisfaction, quality of life and treatment adherence among patients with multiple AKs receiving topical field-directed therapies. Methods: In this observational, multicentre, longitudinal, cohort study, we included 1136 adult patients with discrete, clinically detectable, visible, multiple (three or more lesions in a 25&nbsp;cm 2 area), Grade I/II AKs, for whom the attending dermatologist has prescribed treatment with a topical field-directed therapy. We matched self-reported data and medical information recorded by dermatologists in standard clinical forms. Patients were followed up at two time points (T1: 8&nbsp;days; T2: 25–30&nbsp;days). Results: Most patients were elderly, married, men with poor socio-economic status and multiple lesions of the scalp or face. The majority (n&nbsp;=&nbsp;961) had a prescription of ingenol mebutate (IMB) and 175 received either diclofenac 3% in hyaluronic acid (DHA) or imiquimod 5% (IMQ). Clearance rate at 1&nbsp;month was 84%. Most patients felt very supported (n&nbsp;=&nbsp;819, 73%) and rated dermatologist's explanations very clear (n&nbsp;=&nbsp;608, 54%). Treatment satisfaction (effectiveness and convenience scales) increased along the follow-up, especially for those on IMB (Δ pre-post &nbsp;=&nbsp;−4.00; other: Δ pre-post &nbsp;=&nbsp;−0.25; interaction P&nbsp;&lt;&nbsp;0.001). Communication clarity was associated with higher treatment satisfaction scores (β&nbsp;=&nbsp;0.4–0.6, P&nbsp;&lt;&nbsp;0.01) and lower risk of non-adherence among IMB patients (risk difference: 16%, P&nbsp;&lt;&nbsp;0.01). Conclusion: Communication clarity was associated with patient-reported outcomes and adherence beyond AK-related clinical parameters. Our study questions the current episodic approach to AK management and provides the rationale to develop chronic care models fostering patients’ engagement and treatment alliance. © 2018 European Academy of Dermatology and Venereolog