La ciencia de la salud - En tu propia piel (TVE La2)

Entrevista Dra Susana Puig

Es el órgano más grande y más visible del cuerpo humano, pero a menudo pasa desapercibido. Siempre sensible, la piel nos protege del mundo que nos rodea. Es el momento de empezar a protegerla a ella

http://www.rtve.es/alacarta/videos/la-ciencia-de-la-salud/ciencia-salud-tu-propia-piel/4643931/

#susanapuig #diagnosisdermatologica #cedilp #melanoma #carcinoma #hospitalclinic #cancerpiel #cancerdepiel #deteccioncancerdepiel #tratamientocancerdepiel #microscopia #aedv #topdoctors #fotoproteccionsolar #rayosuva #fotoenvejecimiento #cremassolares #entupropiapiel #protegerlapieldelsol #elsolylapiel #dermatólogo #dermatóloga

Diagnosis Dermatologica Clinic, skin cancer experts

Diagnosis Dermatologica Clinic,

https://youtu.be/hP2p-MoU9Go

Diagnosis Dermatologica is a pioneer center worldwide in the diagnosis and treatment of skin cancer.
Its professionals are experts with recognized international prestige in skin cancer and melanoma and are under the medical direction of the Dr. Susana Puig Sardá and Dr. Josep Malvehy Guilera, head of dermatology service and coordinator of the melanoma group respectively at the Hospital Clínic de Barcelona.

They are responsible for the introduction and validation of numerous diagnostic techniques, such as the digital monitoring method currently implemented around the world and are authors of more than 400 research articles in the most prestigious international journals.

The medical team is made up of dermatologists who are experts in imaging technology, in dermato-oncology and in dermatological therapeutics, being leaders in these fields at a national and international level. We also have a team of nursing professionals and image technicians specialized in the dermatological patient with extensive experience.

#josepmalvehy #susanapuig #skincancer #confocalexvivo #confocalinvivo #melanoma #carcinoma #cáncerdepiel #cedilp #microscopy #molemax #fotofinder #mavig #caliber #dermatologist #topdoctors

Cáncer de piel: Diagnóstico del cáncer

Cáncer de piel: Diagnóstico del cáncer durante la operación: la última técnica para extirpar el tumor al 100%

 Publicación en la Vanguardia 13 de junio 2018. Dia del cáncer de piel 

 #cancerdepiel #euromelanoma2018 #susanapuig #josepmalvehy #diagnosisdermatologica #dermatologiabarcelona #centrodermatologico #dermatologobarcelona #dermatologabarcelona #tratamientocancerdepiel #diagnosticocancerdepiel #confocalexvivo #mavig

Eryfotona y marcadores epigenéticos

Eryfotona y marcadores epigenéticos

https://youtu.be/tDyoSvEMt_I

Trabajos y estudios del efecto de eryfotona en campo de cancerización.

Ugly Duckling Sign as a Major Factor of Efficiency in Melanoma Detection

Importance:

Understanding the contribution of the ugly duckling sign (a nevus that is obviously different from the others in a given individual) in intrapatient comparative analysis (IPCA) of nevi may help improve the detection of melanoma.

Objectives:

To assess the agreement of dermatologists on identification of the ugly duckling sign and estimate the contribution of IPCA to the diagnosis of melanoma.

Design, Setting, and Participants:

The same 2089 digital images of the nevi of a sample of 80 patients (mean age, 42 years [range, 19-80 years]; 33 men and 47 women), as well as 766 dermoscopic images from a subset of 30 patients (mean age, 40 years [range, 21-75 years]; 12 men and 18 women), were randomly presented to the same 9 dermatologists for blinded assessment from September 22, 2011, to April 1, 2013. The first experiment was designed to mimic an IPCA situation, with images of all nevi of each patient shown to the dermatologists, who were asked to identify ugly duckling nevi (UDN). The second experiment was designed to mimic a lesion-focused analysis to identify morphologically suspicious nevi. Data analysis was conducted from November 1, 2012, to June 1, 2013.

Main Outcomes and Measures:

Number of nevi labeled UDN and morphologically suspicious nevi, specificity of lesion-focused analysis and IPCA, and number of nevi identified for biopsy.

Results:

Of the 2089 clinical images of nevi from 80 patients (median number of nevi per patient, 26 [range, 8-81]) and 766 dermoscopic images (median number of nevi per patient, 19 [range, 8-81]), all melanomas were labeled UDN and as morphologically suspicious nevi by the 9 dermatologists. The median number of UDN detected per patient was 0.8 among the clinical images of nevi (mean, 1.0; range, 0.48-2.03) and 1.26 among the dermoscopic images (mean, 1.4; range, 1.00-2.06). The propensity to consider more or fewer nevi as having ugly duckling signs was independent of the presentation (clinical or dermoscopic). The agreement among the dermatologists regarding UDN was lower with dermoscopic images (mean pairwise agreement, 0.53 for clinical images and 0.50 for dermoscopic images). The specificity of IPCA was 0.96 for clinical images and 0.95 for dermoscopic images vs 0.88 and 0.85, respectively, for lesion-focused analysis. When both IPCA and lesion-focused analyses were used, the number of nevi considered for biopsy was reduced by a factor of 6.9 compared with lesion-focused analysis alone.

Conclusions and Relevance:

Intrapatient comparative analysis is of major importance to the effectiveness of the diagnosis of melanoma. Introducing IPCA using the ugly duckling sign in computer-assisted diagnosis systems would be expected to improve performance.

#josepmalvehy #clinicadermatologica #dermatologobarcelona #melanoma #cancerdepiel #diagnosismelanoma #canceruña #skincancer #dermatologabarcelona #bestdoctor #topdoctors #nevus #confocal #susanapuig

Application of in vivo reflectance confocal microscopy (RCM) and ex vivo fluorescence confocal microscopy (FCM) in most common subtypes of Basal Cell Carcinoma and correlation with histopathology

PubMed

Application of in vivo reflectance confocal microscopy (RCM) and ex vivo fluorescence confocal microscopy (FCM) in most common subtypes of Basal Cell Carcinoma and correlation with histopathology.

https://www.ncbi.nlm.nih.gov/pubmed/29405259

Basal cell carcinoma (BCC) accounts for 80% of non-melanoma skin cancer. The identification of the histological subtype is crucial for the correct management of the tumor. In vivo reflectance confocal microscopy (RCM) is a novel technique that has demonstrated high sensitivity and specificity in the in vivo diagnosis of BCC. In an effort to determine reliable criteria for preoperative diagnosis of BCC subtypes, Longo et al. and Peppelman et al., described RCM criteria present in different BCC subtypes.

#josepmalvehy #susanapuig #tonibennassar #melanoma #confocalinvivo #confocal #confocalmicroscopy #microscopiaconfocal #carcinoma #bcc #carcinomas #squamouscellcarcinomas #carcinomabasocelular #DiagnosisDermatologica #topdoctors #dermatologiabarcelona #aad18

Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna

PubMed

Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna

BACKGROUND:

Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques.

OBJECTIVE:

We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images.

METHODS:

223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination were compared. Inter-investigator variability and confidence level in the diagnosis were also evaluated.

RESULTS:

Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, versus 61%) and less specific (81% versus 92%) than dermoscopy for LM/LMM. In particular RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher inter-investigator agreement and a higher confidence level in the diagnosis than dermoscopy.

CONCLUSION:

RCM and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM. This article is protected by copyright. All rights reserved.

https://www.ncbi.nlm.nih.gov/pubmed/29341263

This article is protected by copyright. All rights reserved.

 

 

#confocal #cristinacarrera #josepmalvehy #susanapuig #skincancer #invivo #confocalinvivo #cutaneousmelanoma #lentigo #reflactanceconfocal #cedilp #pubmed #microscopy

 

Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases

PubMed

Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases

Abstract

BACKGROUND:

Reflectance confocal microscopy (RCM) is an imaging device that permits non-invasive visualization of cellular morphology and has been shown to improve diagnostic accuracy of dermoscopically equivocal cutaneous lesions. The application of double reader concordance evaluation of dermoscopy-RCM image sets in retrospective settings and its potential application to telemedicine evaluation has not been tested in a large study population.

OBJECTIVE:

To improve diagnostic sensitivity of RCM image diagnosis using a double reader concordance evaluation approach; to reduce mismanagement of equivocal cutaneous lesions in retrospective consultation and telemedicine settings.

METHODS:

1000 combined dermoscopy-RCM image sets were evaluated in blind by 10 readers with advanced training and internship in dermoscopy and RCM evaluation. We compared sensitivity and specificity of single reader evaluation versus double reader concordance evaluation as well as the effect of diagnostic confidence on lesion management in a retrospective setting.

RESULTS:

Single reader evaluation resulted in an overall sensitivity of 95.2% and specificity of 76.3%, with misdiagnosis of 8 melanomas, 4 basal cell carcinomas and 2 squamous cell carcinomas. Combined double reader evaluation resulted in an overall sensitivity of 98.3% and specificity of 65.5%, with misdiagnosis of 1 in-situ melanoma and 2 basal cell carcinomas.

CONCLUSION:

Evaluation of dermoscopy-RCM image sets of cutaneous lesions by single reader evaluation in retrospective settings is limited by sensitivity levels that may result in potential mismanagement of malignant lesions. Double reader blind concordance evaluation may improve the sensitivity of diagnosis and management safety. The use of a second check can be implemented in telemedicine settings where expert consultation and second opinions may be required.

https://www.ncbi.nlm.nih.gov/pubmed/29121636

#josepmalvehy  #carcinomabasocelular  #dermatoscopy #confocal #cancerdepiel #confocalinvivo, #microscopy #cutaneousmelanoma #squamouscellcarcinomas #carcinomas  #melanomas #reflectanceconfocal #telemedicine

Melanocortin 1 receptor (MC1R) polymorphisms' influence on size and dermoscopic features of nevi.

Melanocortin 1 receptor (MC1R) polymorphisms' influence on size and dermoscopic features of nevi.

https://www.ncbi.nlm.nih.gov/pubmed/28950052

Abstract

The melanocortin 1 receptor (MC1R) is a highly polymorphic gene. The loss-of-function MC1R variants ("R") have been strongly associated with red hair color phenotype and an increased melanoma risk. We sequenced the MC1R gene in 175 healthy individuals to assess the influence of MC1R on nevus phenotype. We identified that MC1R variant carriers had larger nevi both on the back [p-value = .016, adjusted for multiple parameters (adj. p-value)] and on the upper limbs (adj. p-value = .007). Specifically, we identified a positive association between the "R" MC1R variants and visible vessels in nevi [p-value = .033, corrected using the FDR method for multiple comparisons (corrected p-value)], dots and globules in nevi (corrected p-value = .033), nevi with eccentric hyperpigmentation (corrected p-value = .033), a high degree of freckling (adj. p-value = .019), and an associative trend with presence of blue nevi (corrected p-value = .120). In conclusion, the MC1R gene appears to influence the nevus phenotype.

#melanocortin #josepmalvehy #susanapuig #dermoscopic #confocal #Mohs #dermatology #topdoctors #mc1r #melanoma #skincancer #dermatologiabarcelona #clinicadermatologica #cedilp

A practical guide to the handling and administration of talimogene laherparepvec in Europe.

A practical guide to the handling and administration of talimogene laherparepvec in Europe.

https://www.ncbi.nlm.nih.gov/pubmed/28814886

Abstract

Talimogene laherparepvec is a herpes simplex virus-1-based intralesional oncolytic immunotherapy and is the first oncolytic virus to be approved in Europe. It is indicated for the treatment of adults with unresectable melanoma that is regionally or distantly metastatic (stage IIIB, IIIC, and IVM1a) with no bone, brain, lung, or other visceral disease. Talimogene laherparepvec is a genetically modified viral therapy, and its handling needs special attention due to its deep freeze, cold-chain requirements, its potential for viral shedding, and its administration by direct intralesional injection. This review provides a practical overview of handling, storage, and administration procedures for this agent in Europe. Talimogene laherparepvec vials should be transported/stored frozen at a temperature of -90°C to -70°C, and once thawed, vials must not be refrozen. Universal precautions for preparation, administration, and handling should be followed to avoid accidental exposure. Health care providers should wear personal protective equipment, and materials that come into contact with talimogene laherparepvec should be disposed of in accordance with local institutional procedures. Individuals who are immunocompromised or pregnant should not prepare or administer this agent. Talimogene laherparepvec is administered by intralesional injection into cutaneous, subcutaneous, and/or nodal lesions that are visible, palpable, or detectable by ultrasound. Treatment should be continued for ≥6 months. As with other immunotherapies, patients may experience an increase in the size of existing lesion(s) or the appearance of new lesions (ie, progression) prior to achieving a response ("pseudo-progression"). As several health care professionals (eg, physicians [dermatologists, surgeons, oncologists, radiologists], pharmacists, nurses) are involved in different stages of the process, there is a need for good interdisciplinary collaboration when using talimogene laherparepvec. Although there are specific requirements for this agent's storage, handling, administration, and disposal, these can be effectively managed in a real-world clinical setting through the implementation of training programs and straightforward standard operating procedures.

#melanoma #skincancer #confocal #malvehy #doctormalvehy #cedilp #cancerdepiel #talimogene
#dermatologiabarcelona #dermatologobarcelona #cancerdepielbarcelona