60 research outputs found
Non-invasive Approaches for the Diagnosis of Autoimmune/Autoinflammatory Skin Diseases—A Focus on Psoriasis and Lupus erythematosus
The traditional diagnostic gold standard for inflammatory skin lesions of unclear etiology is dermato-histopathology. As this approach requires an invasive skin biopsy, biopsy processing and analysis by specialized histologists, it is a resource intensive approach requiring trained healthcare professionals. In many health care settings access to this diagnostic approach can be difficult and outside emergency cases will usually take several weeks. This scenario leads to delayed or inappropriate treatment given to patients. With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to “measure” samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation—they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin diseases.With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to “measure” samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation – they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin disease
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Comment on "Skin stripping technique: A diagnostic clue for fiberglass dermatitis"
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Optical Coherence Tomography in Nail Research and Diagnosis
Optical coherence tomography (OCT) is a noninvasive and in vivo real-time diagnostic approach that allows for the visualization of skin architecture and cutaneous blood vessels. OCT provides a quick and useful diagnostic imaging technique for a number of nail disorders including psoriasis, glomus tumors, and subungual myxoid cysts and is a valuable addition to other noninvasive imaging tools such as dermoscopy and high-frequency ultrasound
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Authors' Reply to Laneelle et al.: "Vascular Tests for Dermatologists"
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Vascular Tests for Dermatologists
Dermatologists encounter patients with a variety of lower extremity ulcers including those related to venous insufficiency and peripheral arterial disease. Vascular studies, including ankle brachial pressure index, toe pressure, toe brachial index, Doppler arterial waveform, Duplex ultrasonography, and angiography, play an essential role in the prevention, diagnosis, and management of vascular diseases. In fact, dermatologists are often the first medical providers to see patients with complex vascular conditions. Knowledge of the appropriate indications, interpretations, limitations, and advantages of the various vascular studies is critical to the successful and swift management of each patient presenting with a lower extremity ulcer. This study reviews the most commonly ordered arterial and venous studies and discusses the appropriate indications and interpretation of these studies
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Perioperative Anxiety Associated With Mohs Micrographic Surgery: A Survey-Based Study
Mohs micrographic surgery (MMS)-associated anxiety is an important issue that remains poorly discussed. Identifying risk factors for MMS-associated anxiety will better equip physicians to manage patients' preoperative anxiety and result in improved patient satisfaction and outcomes.
This study aims in identification of risk factors that may play a role in MMS-associated anxiety among patients with nonmelanoma skin cancer.
A cross-sectional case series was conducted among MMS patients collect information on patient demographics and surgical locations and to measure perioperative anxiety and quality of life (QoL). In addition, adjusted linear and logistic regression analyses were performed to identify potential risk factors that predict MMS-associated anxiety.
Significant increases in perioperative anxiety were associated with the eyelid area compared with the noneyelid facial area and nonfacial area (p ≤ .05). Patients with graduate degrees exhibited less anxiety compared with ones who received less education (p ≤ .05). Higher perioperative anxiety was associated with a greater impact on QoL (p ≤ .05).
This study identified that surgical location and the patient's educational level are 2 critical predicting factors for perioperative anxiety. Furthermore, perioperative anxiety could negatively affect a patient's quality of life and warrants further investigation into effective management
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