Reflectance confocal microscopy for the diagnosis of skin infections and infestations

Reflectance confocal microscopy (RCM) is a noninvasive real-time imaging technique that has been widely used for the diagnosis of skin cancer. More recently, it has been reported as a useful tool for the diagnosis and management of several inflammatory and infectious skin disorders. This article provides an overview of the current available applications of RCM use in cutaneous infections and infestations. PubMed was used to search the following terms in various combinations: reflectance confocal microscopy, skin, hair, nail, infection, parasitosis, mycosis, virus, bacteria. All papers were accordingly reviewed. In most cutaneous infections or infestations, the main alterations are found in the epidermis and upper dermis, where the accuracy of confocal microscopy is nearly similar to that of histopathology. The high resolution of this technique allows the visualization of most skin parasites, fungi, and a few bacteria. Although viruses cannot be identified because of their small size, viral cytopathic effects can be observed on keratinocytes. In addition, RCM can be used to monitor the response to treatment, thereby reducing unnecessary treatments

Apresentação Dermatoscópica e Microscópica Confocal de Melanoma Raro do Mamilo

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Survey on the status of teledermatology in Austria

Background: The use of digital communication media is becoming increasingly important, with the primary aim of improving both treatment quality and patients' quality of life. In an effort to optimize telemedicine in the field of dermatology, we conducted a survey among dermatologists in Austria. Methods: Statistical analysis of a questionnaire that was developed by a working group and sent to 769 Austrian dermatologists. Results: Overall, 243 dermatologists (132 women/111 men) participated in the survey. Forty-seven percent of male respondents and 55 % of female respondents had already received requests for teledermatology consultations. Seventy-three percent felt that telemedicine was able to contribute to relieving the economic burden on the health care system. Telecommunication between dermatologists and experts (in a given field of dermatology) was deemed to be particularly useful. While telemedicine was also considered to be appropriate for patient follow-up, it was viewed to be less useful for initial consultations. Roughly 50 % of respondents used telemedicine to get a second opinion; one-third used it for initial consultations. Conclusions: Our survey shows that the majority of participants consider teledermatology to be a useful supplement to the current practice of dermatology. Given its particular usefulness for triage purposes, teledermatology can help reduce the number of trips to the hospital and subsequent waiting times. This in turn leads to cost reduction and saves time for both patients and doctors. Legal regulations that include provisions for appropriate reimbursement of physicians would make using teledermatology more attractive

Umfrage zur Situation der Teledermatologie in Österreich

Background: The use of digital communication media is becoming increasingly important, with the primary aim of improving both treatment quality and patients' quality of life. In an effort to optimize telemedicine in the field of dermatology, we conducted a survey among dermatologists in Austria. Methods: Statistical analysis of a questionnaire that was developed by a working group and sent to 769 Austrian dermatologists. Results: Overall, 243 dermatologists (132 women/111 men) participated in the survey. Forty- seven percent of male respondents and 55 % of female respondents had already received requests for teledermatology consultations. Seventy- three percent felt that telemedicine was able to contribute to relieving the economic burden on the health care system. Telecommunication between dermatologists and experts (in a given field of dermatology) was deemed to be particularly useful. While telemedicine was also considered to be appropriate for patient follow- up, it was viewed to be less useful for initial consultations. Roughly 50 % of respondents used telemedicine to get a second opinion; one- third used it for initial consultations. Conclusions: Our survey shows that the majority of participants consider teledermatology to be a useful supplement to the current practice of dermatology. Given its particular usefulness for triage purposes, teledermatology can help reduce the number of trips to the hospital and subsequent waiting times. This in turn leads to cost reduction and saves time for both patients and doctors. Legal regulations that include provisions for appropriate reimbursement of physicians would make using teledermatology more attractive

Imaging of desmoplastic trichoepithelioma by high-definition optical coherence tomography

Desmoplastic trichoepithelioma (DTE) is a rare benign adnexal tumor with follicular differentiation that appears most frequently on the face of young women. It can clinically mimic a variety of skin tumors such as intradermal nevus, sebaceous hyperplasia, and basal cell carcinoma (BCC).1 Because of its overlapping clinical features, the diagnosis of DTE is usually established on histopathology. However, given the predilection of DTE on cosmetically sensitive areas on the face, the indication for biopsy should be as accurate as possible. Several noninvasive imaging techniques have emerged in recent years, aiming for higher accuracy of in vivo diagnosis. These include dermoscopy, reflectance confocal microscopy (RCM), and conventional optical coherence tomography (OCT). High-definition (HD) OCT (Skintell; Agfa HealthCare, Brussels, Belgium) is a recently introduced technique based on the same principles of conventional OCT but differing on its ability to give optical imaging up to 570 \u3bcm deep within the skin, with high resolution of 3 \u3bcm both in axial and lateral directions. The field of view is 1.8 7 1.5 mm, and the total light power at the tissue is less than 3.5 mW. The system works in direct contact with the skin. The interference signal detected by the 2-dimensional imaging sensor is digitized, subsequently transferred to a computer, and displayed through a grayscale or color palette resulting in an OCT image. High-definition OCT is capable of capturing not only slice but also en face images in real time and fast 3-dimensional acquisition. Therefore, HD-OCT allows in vivo examination of the skin, enabling visualization of individual cells with a greater depth than RCM. It also provides cross-sectional imaging like the conventional OCT. Additional technical details are discussed elsewhere. View on Journal Site Related Articles Imaging of Desmoplastic Trichoepithelioma by High-Definition Optical Coherence Tomography Dermatologic Surgery 2015; 41(4): 522\u2013525. MULTIMODALITY IMAGING OF TORPEDO MACULOPATHY WITH SWEPT-SOURCE, EN FACE OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY Retinal Cases & Brief Reports 2018; 12(2): 153\u2013157. Optical Coherence Tomography: Future Applications in Cerebrovascular Imaging Stroke 2018; 49(4): 1044\u20131050

A dangerous fruit of Belladonna

Viene presentato il caso di un melanoma insorto su tatuaggio

Dermoscopy and reflectance confocal microscopy in cutaneous leishmaniasis on the face

Leishmaniasis is a vector-borne intracellular parasitic infection that can present in two major forms, visceral and cutaneous. Cutaneous leishmaniasis (CL) is widely distributed, Spain and Croatia being hypoendemic regions. The disease usually presents as an asymptomatic reddish, mostly ulcerated, papule, often located on the face. The diagnosis is con\ufb01rmed by histopathology and immunohistochemistry. Characteristic dermoscopic structures have been identi\ufb01ed in CL in several studies. Re\ufb02ectance confocal microscopy (RCM) is a technique that allows in vivo visualisation of skin structures at a nearly histological resolution. To the best of our knowledge, only one case of RCM of CL has been published until now