Dermoscopic differentiation of facial lentigo maligna from pigmented actinic keratosis and solar lentigines

The differential diagnosis of lentigo maligna (LM) from pigmented actinic keratosis (PAK) and solar lentigines (SL) remains a challenge for clinicians, especially in the early stages of LM when there are no distinctive dermoscopic features. Objective of this study was to evaluate the frequencies of selective dermoscopic criteria in LM, PAK, and SL and to find the specific combination of distinguishing dermoscopic criteria for LM. Dermoscopists blinded to histopathological diagnosis evaluated 42 LM, 107 PAK, and 16 SL for the presence of predefined dermoscopic criteria. The differences in the presence of dermoscopic criteria between LM and others were evaluated with the chi-squared test or Fisher’s exact test as appropriate. Multivariate logistic regression analysis with the forward conditional stepwise method were performed and odds ratios and corresponding 95% confidence intervals for LM, PAK, and SL were calculated. LM, PAK, and SL showed many common dermoscopic findings. In multivariate logistic regression analysis, darkening at dermoscopic examination (sevenfold), gray circles (sevenfold), target-like pattern (sixfold), gray rhomboids (sixfold), and slate-gray dots/globules (threefold) represented the strongest predictors of LM, while hyperkeratosis (thirteenfold), white circles (twelvefold), and red rhomboids (sixfold) represented the strongest predictors of PAK. The dermoscopic diagnosis of a given lesion should be based on the presence of the combination of specific dermoscopic criteria rather than a single benign or malignant criterion. Our results suggest that the presence of darkening at dermoscopic examination, gray circles, target-like pattern, gray rhomboids, and slate-gray dots/globules should be considered supportive findings for the diagnosis of early LM.</p

Dermoscopic differentiation of facial lentigo maligna from pigmented actinic keratosis and solar lentigines

The differential diagnosis of lentigo maligna (LM) from pigmented actinic keratosis (PAK) and solar lentigines (SL) remains a challenge for clinicians, especially in the early stages of LM when there are no distinctive dermoscopic features. Objective of this study was to evaluate the frequencies of selective dermoscopic criteria in LM, PAK, and SL and to find the specific combination of distinguishing dermoscopic criteria for LM. Dermoscopists blinded to histopathological diagnosis evaluated 42 LM, 107 PAK, and 16 SL for the presence of predefined dermoscopic criteria. The differences in the presence of dermoscopic criteria between LM and others were evaluated with the chi-squared test or Fisher’s exact test as appropriate. Multivariate logistic regression analysis with the forward conditional stepwise method were performed and odds ratios and corresponding 95% confidence intervals for LM, PAK, and SL were calculated. LM, PAK, and SL showed many common dermoscopic findings. In multivariate logistic regression analysis, darkening at dermoscopic examination (sevenfold), gray circles (sevenfold), target-like pattern (sixfold), gray rhomboids (sixfold), and slate-gray dots/globules (threefold) represented the strongest predictors of LM, while hyperkeratosis (thirteenfold), white circles (twelvefold), and red rhomboids (sixfold) represented the strongest predictors of PAK. The dermoscopic diagnosis of a given lesion should be based on the presence of the combination of specific dermoscopic criteria rather than a single benign or malignant criterion. Our results suggest that the presence of darkening at dermoscopic examination, gray circles, target-like pattern, gray rhomboids, and slate-gray dots/globules should be considered supportive findings for the diagnosis of early LM.</p

Lupus band test in patients with borderline systemic lupus erythematosus patients with discoid lesions

Patients with lupus erythematosus (LE) that have discoid lesions who fulfill the four diagnostic criteria of systemic lupus erythematosus (SLE) with only mucocutaneous findings and antinuclear antibody (ANA) positivity were classified as borderline SLE in the literature. Objective of this study was to determine the place of borderline SLE with discoid lesions on the LE spectrum according to the lupus band test (LBT). Lesional and sun-protected non-lesional (SPNL) skin LBTs of 94 patients with LE that had discoid lesions were retrospectively evaluated. Firstly, patients were divided into two main groups: discoid LE (DLE; group A) and SLE (Group B); three subgroups were then classified as DLE (Group A), borderline SLE (Group B1) and SLE (Group B2) using another method. Each group had its own comparisons. Immunoreactant (IR) deposition was observed on the lesional skin in all patients and on the SPNL skin in 42 (44.7%). In patients with borderline SLE, the deposition of IgM was lower on the lesional LBTs, whereas isolated IgG was higher than SLE; thus, it shows similarity with DLE. Additionally, it was also closer to DLE because of the low deposition of C3, multiple IRs, and a double conjugate of IRs on the SPNL skin. However, it showed similarity with SLE in the high percentage of LBT positivity and more immunoglobulin M (IgM) and immunoglobulin G (IgG) deposition on the SPNL skin. The deposition of multiple conjugates on SPNL skin in patients with LE with discoid lesions may reflect systemic involvement. Despite the fact that LBT positivity on SPNL skin in borderline SLE was higher than DLE, less deposition of multiple conjugates compared to SLE indicates that the classification of borderline SLE with discoid lesions in the LE spectrum is questionable.  </p

Comparison of serum lipid parameters between patients with classic cutaneous lichen planus and oral lichen planus

Objectives Previous studies have shown that patients with lichen planus (LP) have an increased occurrence of inflammation-related dyslipidemia. Although classic cutaneous LP (CCLP) and oral LP (OLP) are basically known as the different subtypes of the same disease sharing the common histopathological features, they actually have significant differences both in the clinical behavior and in the molecular inflammatory pathogenesis. We aimed to compare the lipid profile of patients with CCLP and OLP. Materials and methods This study included 120 patients, 30 with isolated CCLP, 30 with isolated OLP, 30 with CCLP + OLP, and 30 controls consecutively admitted to the outpatient clinics of Dermatology Department of Dokuz Eylul University Hospital, Izmir, Turkey. Results Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) values, TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C atherogenic indexes were significantly higher, and HDL-C values were significantly lower in all LP subtypes compared with the controls. Among LP subtypes, although the differences were not statistically significant, TG, TC, and LDL-C values were markedly higher in OLP and OLP + CCLP patients compared with CCLP patients. OLP and CCLP + OLP patients also showed significantly higher TC/HDL-C and LDL-C/HDL-C atherogenic indexes compared with CCLP patients. Conclusions Patients with OLP have a more impaired lipid metabolism and significantly higher atherogenic indexes compared with patients with CCLP. The differences in the molecular inflammatory pathways between OLP and CCLP and the longer disease duration of OLP leading to long-lasting inflammation may elucidate this distinction

Sun-related risk factors, perceived seriousness of disease and accompanying non-melanoma skin cancer in patients with actinic keratoses

Background: Actinic keratoses are the most common premalignant skin lesions worldwide. They are of public health importance since their presence has been associated with the significantly increased incidence of non-melanoma skin cancers (NMSCs), especially when they are numerous and have coalesced into an area with severe photodamage. The current study aimed to evaluate the relationships between sun-related risk factors, perceived seriousness of actinic keratosis (AK), skin cancer examination (SCE) history, and newly detected NMSC in AK patients. Methods: In this descriptive, cross-sectional, case–control study, firstly we examined the demographics, phenotypic traits, sun exposure history, cancer history and newly detected NMSC with full-body skin examinations in AK patients (n = 198) and controls. Secondly, the effects of these parameters, AK knowledge and AK-related clinical findings on the perceived seriousness of AK, SCE history and the presence of newly detected NMSC in AK patients were evaluated. Results: The presence of newly detected NMSC was significantly higher in patients aged ≥65 years, with personal or family skin cancer history, higher AK severity and photoaging grade; however, it was observed that these cases did not perceive AK as a serious illness and did not visit a physician for an SCE previously. Conclusion: This is the first study evaluating sun-related risk factors, knowledge and perceived seriousness of disease and SCE findings of AK patients in Turkey. Our results indicate that national health awareness campaigns and skin cancer scanning programs should be developed especially for the patients under the sun-related risks of AKs and NMSC occurrence. Keywords: Actinic keratoses, Non-melanoma skin cancer, Sun exposure, Knowledge, Perceived seriousness, Full-body skin examinatio

Influence of demographic and clinical characteristics of actinic keratosis patients on illness perceptions and readiness to increase sun protection behaviours: an exploratory study

Background/purpos

Dermoscopic Differentiation of Facial Lentigo Maligna from Pigmented Actinic Keratosis and Solar Lentigines

The differential diagnosis of lentigo maligna (LM) from pigmented actinic keratosis (PAK) and solar lentigines (SL) remains a challenge for clinicians, especially in the early stages of LM when there are no distinctive dermoscopic features. Objective of this study was to evaluate the frequencies of selective dermoscopic criteria in LM, PAK, and SL and to find the specific combination of distinguishing dermoscopic criteria for LM. Dermoscopists blinded to histopathological diagnosis evaluated 42 LM, 107 PAK, and 16 SL for the presence of predefined dermoscopic criteria. The differences in the presence of dermoscopic criteria between LM and others were evaluated with the chi-squared test or Fisher's exact test as appropriate. Multivariate logistic regression analysis with the forward conditional stepwise method were performed and odds ratios and corresponding 95% confidence intervals for LM, PAK, and SL were calculated. LM, PAK, and SL showed many common dermoscopic findings. In multivariate logistic regression analysis, darkening at dermoscopic examination (sevenfold), gray circles (sevenfold), target-like pattern (sixfold), gray rhomboids (sixfold), and slate-gray dots/globules (threefold) represented the strongest predictors of LM, while hyperkeratosis (thirteenfold), white circles (twelvefold), and red rhomboids (sixfold) represented the strongest predictors of PAK. The dermoscopic diagnosis of a given lesion should be based on the presence of the combination of specific dermoscopic criteria rather than a single benign or malignant criterion. Our results suggest that the presence of darkening at dermoscopic examination, gray circles, target-like pattern, gray rhomboids, and slate-gray dots/globules should be considered supportive findings for the diagnosis of early LM

Optimization of open-tube furnace diffusion with Bbr3 liquid source for industrial p-type boron doping process

In this study, optimization of boron emitter for n-type crystalline Si solar cells has been studied in detail. Industrial open-tube (atmospheric) furnace with BBr3 as liquid B source was utilized which is a preferred dopant for the diffusion process of n-type wafers in industry [1] [2]. During the processes, full boat (270 wafers) n-type square samples were used to investigate the uniformity from gas zone to door zone and inside the wafer. To achieve uniform boron emitters on large n-type substrates, parameters of the diffusion process such as temperature, BBr3 flow, BBr3 flow duration and oxygen flow were varied. Resulting emitters went through a BSG removal step followed by sheet resistance mapping characterization. Especially, the tradeoff between BBr3 and O2 flow and their effects on sheet resistance was examined. Additionally, the relation between the borosilicate glass formation and sheet resistance was investigated

Sun-related risk factors, perceived seriousness of disease and accompanying non-melanoma skin cancer in patients with actinic keratoses

Background: Actinic keratoses are the most common premalignant skin lesions worldwide. They are of public health importance since their presence has been associated with the significantly increased incidence of non-melanoma skin cancers (NMSCs), especially when they are numerous and have coalesced into an area with severe photodamage. The current study aimed to evaluate the relationships between sun-related risk factors, perceived seriousness of actinic keratosis (AK), skin cancer examination (SCE) history, and newly detected NMSC in AK patients