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Vitkos EN, Kounatidou NE, Konsolaki E, Printza A, Kyrgidis A, Haßfeld S. Can Loupe magnification be a viable alternative to Operative Microscope magnification for vascular anastomosis in reconstructive surgery? A systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2024:101845. [PMID: 38575496 DOI: 10.1016/j.jormas.2024.101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The aim of this study is to compare the outcomes of vascular anastomosis using loupes magnification versus operative microscope magnification in reconstructive surgery. METHODS We performed a systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library database according to the PRISMA guidelines. Comparative studies between the two techniques and single arm studies reporting on loupes reconstruction were included. Random-effects model meta-analyses were performed. RESULTS Twelve studies, reporting a total of 3908 of flaps, 3409 of which were performed under loupes magnification and 499 under the operative microscope magnification were selected for analysis. No statistically significant differences were observed regarding total flap loss and vascular complication between the two arms. In the Loupes group the rate of total flap loss was 2.65% (95% CI: 1.15-4.63) and the rate of vascular complications 4.49% (95% CI: 2.58-6.84). CONCLUSION Loupes magnification under circumstances can provide a safe and effective alternative to microvascular reconstruction in reconstructive surgery. With respect to flap failure and vascular complication rates, there appear to be no statistically significant differences between the anastomoses conducted under Loupes magnification and the standard operative microscope.
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Affiliation(s)
- Evangelos N Vitkos
- Department of Oral and Maxillofacial Surgery, Klinikum Dortmund and Witten/ Herdecke University, Dortmund Germany.
| | | | - Eleni Konsolaki
- Department of Oral and Maxillofacial Surgery, University Hospital of Heraklion, Heraklion, Greece
| | - Athanassia Printza
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Stefan Haßfeld
- Department of Oral and Maxillofacial Surgery, Klinikum Dortmund and Witten/ Herdecke University, Dortmund Germany
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Dixon AJ, Kyrgidis A, Steinman HK, Dixon JB, Sladden M, Garbe C, Lallas A, Zachary CB, Leiter-Stöppke U, Smith H, Nirenberg A, Zouboulis CC, Longo C, Argenziano G, Apalla Z, Popescu C, Tzellos T, Anderson S, Nanz L, Cleaver L, Thomas JM. Sentinel lymph node biopsy is unreliable in predicting melanoma mortality for both younger and older patients. J Eur Acad Dermatol Venereol 2024; 38:741-751. [PMID: 38168748 DOI: 10.1111/jdv.19772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Melanoma disease patterns vary with patient age. AIM To evaluate sentinel lymph node biopsy (SLNB) in managing melanoma at differing patient ages. METHODS Online prediction tools were applied to compare SLNB positivity (SLNB+) and survival risk at patient ages 20-80. Tübingen melanoma data were used to determine variations in the hazard ratio of SLNB+ for mortality at different patient ages. RESULTS Regardless of tumour thickness, predicted SLNB+ rates were markedly higher than mortality rates for 20-year-old patients. For 80-year-old patients, it is the opposite. DISCUSSION If 1000 20-year-olds with a 0.4 mm thickness non-ulcerated melanoma underwent SLNB, 100 would likely be positive. If all 100 were to be offered adjuvant drug therapy (ADT), fewer than three more melanoma deaths in those 1000 patients would be avoided. In total, 97 patients would have received medication they may never have needed. If 1000 80-year-olds with a 3 mm thickness non-ulcerated melanoma underwent SLNB, only 40 would likely be positive. In total, 274 patients would be predicted to die of melanoma, 245 being SLNB negative and 29 SLNB+. ADT linked to SLNB+ could deny treatment to 89% of these high-risk patients. LIMITATIONS The authors relied on published risk data. CONCLUSION SLNB has poor specificity at predicting mortality in young melanoma patients and poor sensitivity in older patients. SLNB is not indicated in managing cutaneous melanoma for patients under 40 or over 60 years of age. Many such patients could be managed with wide local excision alone in their clinician's office-based practice. For all cutaneous melanoma patients at all ages, linking ADT to BAUSSS biomarker, (an algorithm of Breslow thickness, age, ulceration, subtype, sex and Site) rather than SLNB+ is likely more appropriate. BAUSSS provides a more accurate melanoma-specific mortality risk assessment for patients without burdening them with added surgery, hospitalization, costs or morbidity risk.
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Affiliation(s)
- Anthony J Dixon
- Australasian College of Cutaneous Oncology, Docklands, Victoria, Australia
| | | | | | - John B Dixon
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
| | | | - Claus Garbe
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | | | | | - Ulrike Leiter-Stöppke
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Harvey Smith
- Oxford Dermatology, Perth, Western Australia, Australia
| | | | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Zoe Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Catalin Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | - Lena Nanz
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Dixon AJ, Kyrgidis A, Sladden M, Nirenberg A, Steinman HK, Smith H, Zachary CB, Anderson S, Leiter-Stöppke U, Longo C, Apalla Z. BAUSSS biomarker further validated as a key risk staging tool for patients with primary melanoma. J Eur Acad Dermatol Venereol 2024. [PMID: 38375764 DOI: 10.1111/jdv.19889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Anthony J Dixon
- Australasian College of Cutaneous Oncology, Docklands, Victoria, Australia
| | | | | | | | | | - Harvey Smith
- Oxford Dermatology, Mt Hawthorn, Perth, Western Australia, Australia
| | | | | | - Ulrike Leiter-Stöppke
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Zoe Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
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Vlassi A, Vitkos E, Michailidou D, Lykoudis PM, Kioroglou L, Kyrgidis A, Tilaveridis I, Dardavesis T. Stress, Professional Burnout, and Employee Efficiency in the Greek National Organization for the Provision of Health Services. Clin Pract 2023; 13:1541-1548. [PMID: 38131684 PMCID: PMC10742003 DOI: 10.3390/clinpract13060135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Workplace stress and burnout in the Greek healthcare system had been considered severe even before the high pressure of the COVID-19 pandemic. We aimed to investigate occupational quality of life and burnout effects on workplace errors among the administrative staff in the Greek healthcare system. METHODS We enrolled 120 administrative healthcare employee participants between April and May 2019. Occupational burnout was assessed using the Maslach Burnout Inventory-Human Services Survey and the Hospital Anxiety and Depression Scale. FINDINGS Inadequate staffing, a low sense of well-being, exhaustion, and low family income were associated with workplace errors. Increased workload and staff shortages were associated with occupation related quality of life. CONCLUSIONS Targeted interventions supporting healthcare staff mental health are warranted. APPLICATION TO PRACTICE Wellness and professional burnout can affect professional efficiency and are associated with workplace errors in the healthcare sector. Targeted interventions are warranted to support the mental health of healthcare staff during work and to prevent incidents of post-traumatic stress. Shortages of staffing may lead to an increase in the cost of the provided services.
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Affiliation(s)
- Alexandra Vlassi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.V.)
| | - Evangelos Vitkos
- Department of Oral and Maxillofacial Surgery, University Hospital of Crete, 715 00 Heraklion, Greece
| | - Despoina Michailidou
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, 570 10 Thessaloniki, Greece
| | - Panagis M. Lykoudis
- Consultant Hepato-Pancreato-Biliary Surgeon Honorary Lecturer, Division of Surgery & Interventional Science, University College London, London NW3 2PS, UK
| | - Lambrini Kioroglou
- School of Medicine and School of Law, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, 570 10 Thessaloniki, Greece
| | - Ioannis Tilaveridis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Theodoros Dardavesis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.V.)
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Dixon A, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Tzellos T, Cleaver L, Zachary C, Anderson S, Thomas JM. Online prediction tools for melanoma survival: A comparison. J Eur Acad Dermatol Venereol 2023; 37:1999-2003. [PMID: 37210649 DOI: 10.1111/jdv.19219] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Breslow thickness, patient age and ulceration are the three most valuable clinical and pathological predictors of melanoma survival. A readily available reliable online tool that accurately considers these and other predictors could be valuable for clinicians managing melanoma patients. OBJECTIVE To compare online melanoma survival prediction tools that request user input on clinical and pathological features. METHODS Search engines were used to identify available predictive nomograms. For each, clinical and pathological predictors were compared. RESULTS Three tools were identified. The American Joint Committee on Cancer tool inappropriately rated thin tumours as higher risk than intermediate tumours. The University of Louisville tool was found to have six shortcomings: a requirement for sentinel node biopsy, unavailable input of thin melanoma or patients over 70 years of age and less reliable hazard ratio calculations for age, ulceration and tumour thickness. The LifeMath.net tool was found to appropriately consider tumour thickness, ulceration, age, sex, site and tumour subtype in predicting survival. LIMITATIONS The authors did not have access to the base data used to compile various prediction tools. CONCLUSION The LifeMath.net prediction tool is the most reliable for clinicians in counselling patients with newly diagnosed primary cutaneous melanoma regarding their survival prospects.
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Affiliation(s)
- A Dixon
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - H K Steinman
- Campbell University, Buies Creek, North Carolina, USA
| | - A Kyrgidis
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - H Smith
- Oxford Dermatology, Western Australia, Perth, Australia
| | - M Sladden
- University of Tasmania, Tasmania, Launceston, Australia
| | - C Zouboulis
- Staedtisches Klinikum Dessau, Brandenburg Medical School, Dessau, Germany
| | - G Argenziano
- Dermatology, University of Campania, Naples, Italy
| | - Z Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Longo
- University of Modena and Reggio Emilia, Modena, Italy
- Azienda Unita Sanitaria Locale, IRCCS di Reggio Emilia, Skin Cancer Center, Regio Emilia, Italy
| | - A Nirenberg
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - C Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - T Tzellos
- Arctic University of Norway, Tromsø, Norway
| | - L Cleaver
- AT Still University, Missouri, Kirksville, USA
| | - C Zachary
- University of California Irvine, California, Irvine, USA
| | - S Anderson
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - J M Thomas
- Formerly of Royal Marsden Hospital, Chelsea, London, UK
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Pampena R, Piccolo V, Muscianese M, Kyrgidis A, Lai M, Russo T, Briatico G, Di Brizzi EV, Cascone G, Pellerone S, Longo C, Moscarella E, Argenziano G. Melanoma in children: A systematic review and individual patient meta-analysis. J Eur Acad Dermatol Venereol 2023; 37:1758-1776. [PMID: 37210654 DOI: 10.1111/jdv.19220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/07/2023] [Indexed: 05/22/2023]
Abstract
The current evidence on paediatric melanoma is heterogeneous, especially regarding the prognosis of different histological subtypes. We sought to systematically review the evidence on paediatric melanoma, highlighting the major sources of heterogeneity and focusing on available data on single patients. A systematic search was performed from 1948 to 25 January 2021. Only studies reporting at least one case of cutaneous melanoma in patients aged ≤18 years were included. Unknown primary and uncertain malignant melanomas were excluded. Three couples of authors independently performed title/abstract screening and two different authors reviewed all the relevant full texts. The selected articles were manually cross-checked for overlapping data for qualitative synthesis. Subsequently data on single patients were extracted to perform a patient-level meta-analysis. PROSPERO registration number: CRD42021233248. The main outcomes were melanoma-specific survival (MSS) and progression-free survival (PFS) outcomes. Separate analyses were done of cases with complete information on histologic subtype, focusing on superficial spreading (SSM), nodular (NM) and spitzoid melanomas, as well as of those classified as de-novo (DNM) and acquired or congenital nevus-associated melanomas (NAM). The qualitative synthesis covered 266 studies; however, data on single patients were available from 213 studies including 1002 patients. Among histologic subtypes, NM had a lower MSS than both SSM and spitzoid melanoma, and a lower PFS than SSM. Spitzoid melanoma had a significantly higher progression risk than SSM and trended toward lower mortality. Focusing on nevus-associated status, DNM demonstrated better MSS after progression than congenital NAM, and no differences were highlighted in PFS. Our findings describe the existence of different biological patterns in paediatric melanoma. Specifically, spitzoid melanomas demonstrated intermediate behaviour between SSM and NM and showed a high risk of nodal progression but low mortality. This raises the question of whether spitzoid lesions are being over-diagnosed as melanoma in childhood.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michela Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Russo
- Dermatology Unit, University of Campania, Naples, Italy
| | | | | | | | | | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Ilut PA, Camela E, Lallas K, Papageorgiou C, Manoli SM, Kyrgidis A, Liopyris K, Sgouros D, Apalla Z, Lallas A. The Natural Evolution of Nevi with Peripheral Globules. Dermatology 2023; 239:760-767. [PMID: 37279706 DOI: 10.1159/000531004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Peripheral globules (PG) in melanocytic lesions represent a concerning dermoscopic feature since they might be present in growing nevi and melanomas. Their natural evolution has not been fully elucidated, and an age-based management approach has been recommended. OBJECTIVES The aim of this study was to calculate the growth rate of lesions with PG and investigate possible association with age, sex, location, and the global dermoscopic pattern. METHODS We retrospectively selected the lesions of interest from a cohort of Caucasian patients who underwent sequential digital dermoscopy monitoring. Lesions with PG distributed at 75% or more of their circumference with available follow-up images or histopathologic report were included. The surface area was automatically calculated with the help of an incorporated tool used in the acquisition of the images. The images were also evaluated by independent investigators for the presence of pre-defined criteria. Growth-curve models were used to assess the growth rate. The outcome variable was the area of nevi in mm2, and scatterplots with Lowess curves were used to present the mean change of nevi during follow-up. RESULTS A total of 208 lesions from 98 patients with a median age of 36 years (range 15-75) were included. The median follow-up time was 18 months (range 4-48). The mean growth rate for all nevi was 0.16 mm2/month (95% CI, 0.14-0.18, p < 0.001), ranging from -0.29 to 0.61 mm2/month. The growth rate was higher in nevi with a homogeneous dermoscopic pattern (p < 0.001). The number of peripheral globules during follow-up varied from increasing to complete disappearance. None of the lesions developed any melanoma-specific structure at follow-up. CONCLUSION Nevi with PG grew at a mean rate of 0.16 mm2/month, and the growth rate was independent of age, gender, or anatomic location. Nevi with homogeneous pattern demonstrated the highest growth rate in our cohort. None of the monitored nevi with PG developed melanoma-specific criteria at follow-up.
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Affiliation(s)
- Paula Anca Ilut
- Department of Dermatology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elisa Camela
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Konstantinos Lallas
- Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Sofia-Magdalini Manoli
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou,", Thessaloniki, Greece
| | - Konstantinos Liopyris
- Department of Dermatology, University of Athens, Andreas Sygros Hospital for Cutaneous and Venereal Diseases, Athens, Greece
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dimitrios Sgouros
- Second Department of Dermatology and Venereology, ATTIKON General University Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Zoe Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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Papageorgiou C, Kyrgidis A, Ilut PA, Gkentsidi T, Manoli SM, Camela E, Apalla Z, Lallas A. Acral Melanocytic Nevi in a High-Risk Population: Prevalence, Clinical Characteristics and Dermatoscopic Patterns. Dermatology 2023; 239:753-759. [PMID: 37231917 DOI: 10.1159/000531055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The prevalence of acral nevi and their dermatoscopic patterns have been mainly studied in Asian populations. Few data exist on the prevalence and clinico-dermatoscopic morphology of acral nevi in white populations. OBJECTIVES The aim of this study was to assess the prevalence of acral nevi and evaluate their features in a cohort of Caucasian individuals at high risk for skin cancer. METHODS We prospectively examined the palms and soles of 680 high-risk patients who underwent total body clinical and dermatoscopic documentation, as a part of their routine follow-up, between January 2016 and March 2020 at a skin cancer referral center in Greece. RESULTS Overall, 334 acral lesions were detected in 217 (37.0%) of 585 patients in the study. The presence of acral nevi was associated with 2.6 higher odds of a total nevus count higher than 50 (OR: 2.6, p < 0.05, confidence intervals [CI]: 1.11-6.09). Of 334 acral nevi, 65.0% were clinically flat and 35.0% were clinically palpable. Palpable lesion had 19-fold higher probability of being located on the sole (OR: 19.44, p < 0.05, CI: 3.91-96.7). The parallel furrow pattern was present in 147 lesions (44.0%). In 76 lesions (22.8%), we observed a previously undefined pattern consisting of wavy lines, which was correlated with clinically palpable lesions (p < 0.001). The third most common pattern was homogeneous (10.5%), followed by the fibrillar (8.7%), the lattice-like (7.2%), the reticular (3.6%), and globular (3.3%). CONCLUSION We observed a higher prevalence of benign acral melanocytic lesions than expected, probably related to our cohort selection of patients at high risk for developing skin cancer. Our study confirms the previously described dermatoscopic patterns and provides novel insights into the dermatoscopic morphology of acral palpable nevi, for which we described a new benign pattern consisting of wavy lines.
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Affiliation(s)
- Chryssoula Papageorgiou
- Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University, Thessaloniki, Greece
| | - Paula Anca Ilut
- Dermatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Theodosia Gkentsidi
- First Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia-Magdalini Manoli
- First Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Zoe Apalla
- Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Apalla Z, Drongoula O, Lallas K, Kyrgidis A, Sgouros D, Boziou M, Katoulis A, Lazaridou E, Barkis I, Lallas A. The direct impact of the National skin cancer awareness month campaign on melanoma diagnosis in Greece. J Eur Acad Dermatol Venereol 2023. [PMID: 37062027 DOI: 10.1111/jdv.19118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/14/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Zoe Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ourania Drongoula
- Department of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Konstantinos Lallas
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki
| | - Athanassios Kyrgidis
- Department of Maxillofacial Surgery, Papanikolaou General Hospital, Thessaloniki, Greece
| | - Dimitrios Sgouros
- Second Department of Dermatology, National and Kapodistrian University of Athens, Greece
| | - Maria Boziou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Alexandros Katoulis
- Second Department of Dermatology, National and Kapodistrian University of Athens, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ioannis Barkis
- Private practice, Athens, Greece, President of the Hellenic Society of Dermatology and Venereology
| | - Aimilios Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Dixon AJ, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Dixon JB, Tzellos T, Zachary C, Cleaver L, Anderson S, Zagarella S, Thomas JM. Improved methodology in determining melanoma mortality and selecting patients for immunotherapy. J Eur Acad Dermatol Venereol 2023. [PMID: 36785984 DOI: 10.1111/jdv.18951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/08/2023] [Indexed: 02/15/2023]
Affiliation(s)
- A J Dixon
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - H K Steinman
- Campbell University, Buies Creek, North Carolina, USA
| | - A Kyrgidis
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - H Smith
- Oxford Dermatology, Perth, Western Australia, Australia
| | - M Sladden
- University of Tasmania, Launceston, Tasmania, Australia
| | - C Zouboulis
- Dessau Medical Center, Brandenburg Medical School, Dessau, Germany
| | | | - Z Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Longo
- University of Modena and Reggio Emilia, Modena, Italy
| | - A Nirenberg
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - C Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - J B Dixon
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - T Tzellos
- Arctic University of Norway, Tromsø, Norway
| | - C Zachary
- University of California, Irvine, California, USA
| | - L Cleaver
- A.T. Still University, Kirksville, Missouri, USA
| | - S Anderson
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - S Zagarella
- University of Sydney, Sydney, New South Wales, Australia
| | - J M Thomas
- Formerly of Royal Marsden Hospital, London, UK
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11
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Tzellos T, van Straalen KR, Kyrgidis A, Alavi A, Goldfarb N, Gulliver W, Jemec GBE, Lowes MA, Marzano AV, Prens EP, Sayed CJ, van der Zee HH, Zouboulis CC. Development and validation of IHS4-55, an IHS4 dichotomous outcome to assess treatment effect for hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2023; 37:395-401. [PMID: 36184889 DOI: 10.1111/jdv.18632] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Validated, inclusive and easy-to-use outcomes for hidradenitis suppurativa are essential both in the clinical trial setting and clinical practice. The continuous IHS4 is a validated tool that dynamically assesses nodules/abscesses/draining tunnels and classifies disease severity as mild/moderate/severe. However, dichotomous outcomes are often required for clinical trials reporting. OBJECTIVE To develop and validate a dichotomous outcome based on IHS4 that can be used in clinical trial settings and day-to-day clinical practice. METHODS De-identified data from the PIONEER-I and -II studies were accessed through Vivli. Potential IHS4 thresholds were analysed using baseline to Week 12 data from adalimumab- and placebo-treated hidradenitis suppurativa patients in the PIONEER-I trial. The final threshold was chosen based on its ability to discriminate between patients treated with adalimumab or placebo and its association with reduction in inflammatory lesions. The final threshold was validated using data from baseline to Week 12 from adalimumab- and placebo-treated hidradenitis suppurativa patients in both the PIONEER-II and the combined PIONEER-I and -II studies. RESULTS The best performing cut-off for the IHS4 was a 55% reduction of the IHS4 score (IHS4-55). Patients who achieved the IHS4-55 had an odd's ratio of 2.00 [95%-CI 1.26-3.18, p = 0.003], 2.79 (95%-CI 1.76-4.43, p < 0.001) and 2.16 (95%-CI 1.43-3.29, p < 0.001) for being treated with adalimumab rather than placebo in PIONEER-I, PIONEER-II and the combined dataset, respectively. Additionally, the achievement of the IHS4-55 was associated with a significant reduction in inflammatory nodules, abscesses and draining tunnels in all analysed datasets. CONCLUSIONS IHS4-55, a novel dichotomous IHS4 version, based on a 55% reduction of the total score was developed. The IHS4-55 performs similarly to the HiSCR in discriminating between adalimumab- and placebo-treated hidradenitis suppurativa patients and shows significant associations with reductions in lesion counts. Moreover, the IHS4-55 addresses some of the HiSCR drawbacks by dynamically including draining tunnels in a validated manner. By allowing the analysis of hidradenitis suppurativa patients with an abscess and nodule count below 3 but many draining tunnels, this outcome measure will improve inclusivity in clinical trials.
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Affiliation(s)
- Thrasivoulos Tzellos
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Nordland Hospital Trust, Bodø, Norway
| | - Kelsey R van Straalen
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Athanassios Kyrgidis
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Maxillofacial Surgery, Papanikolaou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Afsaneh Alavi
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Noah Goldfarb
- Departments of Medicine and Dermatology, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.,Departments of Medicine and Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Wayne Gulliver
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Gregor B E Jemec
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | | | - Angelo Valerio Marzano
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Errol P Prens
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Christopher J Sayed
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hessel H van der Zee
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Christos C Zouboulis
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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12
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Pantazi G, Evangelopoulos I, Evangelopoulos C, Tilaveridou S, Iakovou I, Kyrgidis A, Tilaveridis I. Remodelling of the superficial vascular network of skin flaps in rats, following a vasodilatory cream application, before elevation. J Plast Surg Hand Surg 2023; 57:206-215. [PMID: 35195490 DOI: 10.1080/2000656x.2022.2039679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Flap necrosis on random pattern skin flaps continues to be a challenge. In this study, we evaluated whether topical application of a vasodilator substance (the prostaglandin PGI2 analogue, Iloprost®, in cream form) as pre-treatment, would increase blood flow and improve flap viability. Wistar rats randomly allocated into four groups with 7 rats per group and two flaps 4cm × 2cm in the same rat i.e. 56 flaps were developed. Flaps on the wright side received pre-treatment with Cream in different drug concentrations, 2.5μgr/gr, 5 μgr/gr, and 10μgr/gr and 20 μgr/gr containing the active factor Iloprost®® ZK 36,374(M. W 360.5) prepared with white petrolatum as a base. Flaps on the left side received placebo cream (white petrolatum). After 10 days of flap pre-treatment, evaluation of blood flow by laser Doppler flowmetry (LDF) were recorded, then flap elevation and re suturing back were performed. After 7 days we estimated flap viability on digital imaging and the percentages of flap survival estimated. Means and standard deviations were used to describe blood flow measurements and survival percentages. The significance was set at 0.05 in all cases and the analysis were carried out with the use of the SPSS v23.0. Furthermore, we performed dynamic analyses of circulation using the radioisotope 99mTc which confirmed hyperaemia of the treated areas relative to that observed in control areas. These findings demonstrated that pretreatment of skin flaps with Iloprost® cream for 10 days prior to elevation increased blood flow in the flap and improved their overall survival rate.
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Affiliation(s)
- Glykeria Pantazi
- Department of Plastic and Reconstructive Surgery, R.G.H. "George Papanikolaou", Exohi Thessaloniki, Greece
| | | | | | - Sofia Tilaveridou
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Iakovou
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Academic Department of Nuclear Medicine, University Hospital AHEPA School of Medicine Thessaloniki, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, R.G.H. "George Papanikolaou", Exohi, Thessaloniki, Greece
| | - Ioannis Tilaveridis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, R.G.H. "George Papanikolaou", Exohi, Thessaloniki, Greece
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13
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van Straalen KR, Tzellos T, Alavi A, Benhadou F, Cuenca-Barrales C, Daxhelet M, Daoud M, Efthymiou O, Giamarellos-Bourboulis EJ, Guillem P, Gulliver W, Jemec GBE, Katoulis A, Koenig A, Lazaridou E, Lowes MA, Marzano AV, Matusiak Ł, Molina-Leyva A, Moltrasio C, Pinter A, Potenza C, Prens EP, Romaní J, Saunte DML, Sayed CJ, Skroza N, Stergianou D, Szepietowski JC, Trigoni A, Vilarrasa E, Kyrgidis A, Zouboulis CC, van der Zee HH. External validation of the IHS4-55 in a European antibiotic-treated HS cohort. Dermatology 2023:000528968. [PMID: 36630943 DOI: 10.1159/000528968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/09/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Previously, a new dichotomous outcome was developed, calculated as 55% reduction in the International Hidradenitis Suppurativa 4 score (IHS4-55). It was validated in datasets of adalimumab and placebo treated HS patients. External validation is an important aspect of clinical outcomes. OBJECTIVES We aimed to externally validate the novel dichotomous IHS4-55 in a non-biologic treated dataset of HS patients. METHODS Data from a previously published European-wide prospective clinical study of antibiotic treatment of HS patients was used to assess the association of IHS4-55 achievement with individual reduction in inflammatory nodules, abscesses and draining tunnels. Moreover, the associations between IHS4-55 positivity and achievement of the minimal clinically important differences (MCID) for Dermatology Life Quality Index (DLQI), numerical rating scale (NRS) Pain, and NRS Pruritus were analyzed. RESULTS Data was obtained from 283 individual patients, of which 36.4% (103/283) were treated with clindamycin and rifampicin and 63.6% (180/283) with tetracyclines for 12 weeks. Achievers of the IHS4-55 demonstrated a significant reduction the counts of inflammatory nodules, abscesses, and draining tunnels (all p<0.001). Additionally, IHS4-55 achievers had an odds ratio (OR) for achieving the minimal clinically important difference (MCID) of DLQI, NRS Pain and NRS Pruritus of 2.16 (95% CI 1.28-3.65, p<0.01), 1.79 (95% CI 1.10-2.91, p<0.05), and 1.95 (95% CI 1.18-3.22, p<0.01), respectively. CONCLUSIONS This study shows the external validity of the novel IHS4-55 by demonstrating a significant association between IHS4-55 achievement and a reduction in inflammatory lesion counts as well as achievement of MCIDs for DLQI, NRS Pain and NRS Pruritus in an antibiotic-treated cohort. These findings support the use of the IHS4-55 as a novel primary outcome measure in clinical trials.
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14
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Vitkos EN, Kounatidou NE, Agoropoulos K, Kyrgidis A. Avascular necrosis of the maxilla after orthognathic surgery, a devastating complication? A systematic review of reported cases and clinical considerations. Acta Chir Plast 2023; 65:117-127. [PMID: 38538299 DOI: 10.48095/ccachp2023117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE The purpose of this study was to collect and present all the available evidence regarding avascular maxillary necrosis following maxillary osteotomy for orthognathic surgery. METHODS We performed a systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library dataset in accordance with the PRISMA guideline. We included studies that report on avascular maxillary necrosis after any maxillary osteotomy used in the frame of orthognathic surgery. RESULTS Sixteen studies reporting a total of 65 patients with postoperative avascular maxillary necrosis were included. Those reported avascular necrosis in 32 female patients and 19 male patients. Multisegmented Le Fort I osteotomy was the most common type of related operation amongst the patients followed by single segment Le Fort I osteotomy. CONCLUSIONS Although avascular maxillary necrosis is a very rare complication after maxillary orthognathic surgery it can be complicated with partial / complete loss of the maxilla. A personalized selection of the surgical technique should be made for any patient. Caution is warranted in cleft patients and in patients undergoing multisegmented Le Fort I osteotomies, so that the vitality of the maxilla and especially its anterior part is preserved. In the case when avascular necrosis arises, management should be immediate and precise. As for the reconstruction, it needs to be tailored according to the maxillary defect.
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15
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Nikolaou VA, Apalla Z, Carrera C, Fattore D, Sollena P, Riganti J, Segura S, Freites-Martinez A, Lallas K, Romano MC, Oikonomou C, Starace M, Dimopoulos MA, Kyrgidis A, Lazaridou E, Giavedoni P, Annunziata MC, Peris K, Echeverría M, Lopez-Tujillo E, Syrigos K, Papageorgiou C, Podlipnik S, Fabbrocini G, Torre AC, Kemanetzi C, Villa-Crespo L, Lallas A, Stratigos AJ, Sibaud V. Clinical associations and classification of immune checkpoint inhibitor-induced cutaneous toxicities: a multicentre study from the European Academy of Dermatology and Venereology Task Force of Dermatology for Cancer Patients. Br J Dermatol 2022; 187:962-969. [PMID: 35861701 DOI: 10.1111/bjd.21781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cutaneous immune-related adverse events (irAEs) represent the most frequent toxicities induced by immune checkpoint inhibitors (ICIs). OBJECTIVES To investigate clinical associations of cutaneous toxicities induced by different ICI therapies. METHODS This was a multicentre retrospective international cohort study of patients with cancer who developed cutaneous irAEs under ICI therapy. Analysis was performed of the rates and basic characteristics of all cutaneous toxicities, and identification of any associations was performed using univariate and multivariate models. RESULTS In total, 762 patients were included, who developed 993 cutaneous toxicities. Forty different types of skin toxicities were identified. Psoriasis (175 patients, 23·0%) and pruritus (171 patients, 22·4%) were the most common toxicities, followed by macular rash (161 patients, 21·1%) and eczematous-type reactions (150 patients, 19·7%). Multivariate analysis showed that among patients with macular rash, vitiligo or multiple toxicities, patients received ICIs more frequently for melanoma than for NSCLC. Moreover, anti-CTLA4 was less frequent than anti-programmed death 1 treatment in patients with macular rash [odds ratio (OR) 0·11, 95% confidence interval (CI) 0·01-0·76] and vitiligo (OR 0·07, 95% CI 0·006-0·78). A significant association was also seen in patients treated with a combination of ICI and chemotherapy vs. ICI monotherapy. They less frequently developed psoriasis (OR 0·08, 95% CI 0·02-0·31), lichenoid reactions (OR 0·15, 95% CI 0·03-0·77) and eczematous reactions (OR 0·24, 95% CI 0·07-0·78), all compared with pruritic rash. CONCLUSIONS Our study showed that skin-oriented toxicities do not share a single pattern and are related to several factors, including the specific agent administered and the underlying malignancy treated. Follow-up plans should be individualized in order to minimize the risk for severe reactions that could compromise optimum therapeutic outcome. What is already known about this topic? Patients with cancer treated with different immune checkpoint inhibitors (ICIs) carry an increased risk of developing various types of skin toxicities. What are the clinical implications of this work? In this multicentre cohort study we showed that ICI-related skin toxicities do not share a single pattern and may depend on several factors, including the specific agent administered and the underlying malignancy. Among patients with macular rash, vitiligo or multiple skin toxicities, patients received ICIs more frequently for melanoma than for non-small cell lung cancer. The combination of ICI and chemotherapy compared with ICI monotherapy occurred to a lesser extent in patients with psoriatic rash lichenoid and eczematous reactions, compared with patients with pruritus. Clinical awareness and specialized dermatological consultation should be advocated.
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Affiliation(s)
- Vasiliki A Nikolaou
- First Department of Dermatology, 'Andreas Sygros' Hospital for Skin Diseases, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Cristina Carrera
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.,Melanoma Group, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro Sollena
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Julia Riganti
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Sonia Segura
- Department of Dermatology, Hospital del Mar - Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Azael Freites-Martinez
- Oncodermatology Clinic at Hospital Ruber Juan Bravo and Universidad Europea, Madrid, Spain
| | - Konstantinos Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Michela Starace
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Meletios A Dimopoulos
- Hematology & Medical Oncology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Athanassios Kyrgidis
- Department of Clinical Pharmacology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Priscila Giavedoni
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ketty Peris
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Echeverría
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Emilio Lopez-Tujillo
- Department of Dermatology, Hospital del Mar - Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Konstandinos Syrigos
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Greece
| | | | - Sebastian Podlipnik
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.,Melanoma Group, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ana C Torre
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Christina Kemanetzi
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lorena Villa-Crespo
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander J Stratigos
- First Department of Dermatology, 'Andreas Sygros' Hospital for Skin Diseases, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vincent Sibaud
- Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
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16
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Tatsis D, Grivas T, Antoniou A, Argyriadou S, Kyrgidis A. General Medical Practitioners' Preferences in Referring Patients with Head and Neck Disorders; A Cross-Sectional Evaluative Study in Greece. Indian J Otolaryngol Head Neck Surg 2022; 74:5668-5674. [PMID: 36742810 PMCID: PMC9895543 DOI: 10.1007/s12070-021-02991-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
Oral and Maxillofacial Surgery (OMFS) is among the newest established medical specialties and its full scope is not fully known by other specialties. The aim of the present study is to record the perception of OMFS scope by general medical practitioners (GMPs) of the National Health Service in Greece. A cross-sectional study was conducted in GMPs via a structured questionnaire. Questions involved various head and neck disorders and possible referring medical specialties. 66 answered questionnaires were included in this study. Participants were established to regional health practices, health centres or hospitals. 77.2% of the participants would refer a facial laceration to a plastic surgeon and only 7.2% to an OMFS. 89.3% would refer a zygoma fracture to an OMFS and 10.6% to an ENT. The vast majority would refer a tongue cancer, a neck mass and a mouth lesion to an ENT (74.8%, 81.8%, and 48% respectively). OMFS scope awareness of GMPs can be considered low. Thus, widening the knowledge of OMFS practice in primary grade medical practitioners is of high importance. Early exposure of medical students to the specialty could be a valid option to achieve this target.
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Affiliation(s)
- Dimitris Tatsis
- Department of Oral and Maxillofacial Surgery, Specialized Cancer Treatment and Reconstruction Center, General Hospital “George Papanikolaou”, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Grivas
- Department of Oral and Maxillofacial Surgery, Specialized Cancer Treatment and Reconstruction Center, General Hospital “George Papanikolaou”, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Antoniou
- Department of Oral and Maxillofacial Surgery, Specialized Cancer Treatment and Reconstruction Center, General Hospital “George Papanikolaou”, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Argyriadou
- Former Head of Chrysoupoli Health Centre, Former Director of GMP Training in ELEGEIA GMP Society, Chrysoupoli, Kavala, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Specialized Cancer Treatment and Reconstruction Center, General Hospital “George Papanikolaou”, Aristotle University of Thessaloniki, Thessaloniki, Greece
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17
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Dixon A, Kyrgidis A, Zachary C, Dixon J, Popescu C, Sladden M, Apalla Z, Anderson S, Argenziano G, Ioannides D, Nirenberg A, Lallas A, Zagarella S, Longo C, Smith H, Steinman H, Tzellos T, Cleaver L, Leahey K, Zouboulis CC, Thomas JM. Multicentre Selective Lymphadenectomy Trial 1: key primary data remain unavailable. Br J Dermatol 2022; 187:997-998. [PMID: 35730244 DOI: 10.1111/bjd.21712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/08/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Anthony Dixon
- Australasian College of Cutaneous Oncology, Melbourne, VIC, Australia
| | | | | | - John Dixon
- Swinburne University of Technology, Melbourne, VIC, Australia
| | - Catalin Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Zoe Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | | | | | | | | | | | | | | | - Ken Leahey
- Harbour Medical Services, Adelaide, SA, Australia
| | - Christos C Zouboulis
- Brandenburg Medical School, Theodor Fontane and Faculty of Health Sciences, Brandenburg, Dessau, Germany
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18
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Vitkos EN, Papadopoulos KA, Dimasis P, Weissinger C, Kyrgidis A. One miniplate versus two miniplates in the fixation of mandibular angle fractures. An updated systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2022; 123:e865-e873. [PMID: 35872351 DOI: 10.1016/j.jormas.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to compare the outcomes after using one miniplate fixation in the external oblique ridge versus two miniplate fixation for mandibular angle fractures. METHODS A systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library database was performed (last search date: 04 February 2022) according to the PRISMA guidelines. The research question was addressed using the PICO criteria. Only comparative studies between the two techniques were included. Random-effects model meta-analyses were performed. RESULTS Seventeen studies, comprising a total of 1667 patients, 846 undergoing one miniplate fixation and 854 undergoing two miniplate fixation for mandibular angle fractures were identified. No statistically significant differences were observed regarding surgical site infection (odds ratio [OR]= 0.94, 95% confidence interval [CI]: [0.69] - [1.28], p = 0.68, I2=0.00%), post-operative malocclusion (OR= 0.97, 95% CI: [0.53] - [1.18], p = 0.25, I2=0.00%), post-operative neurosensory dysfunction (OR= 0.67, 95% CI: [0.37] - [1.22], p = 0.19, I2=73.93%), pseudoarthrosis formation (OR=0.90, 95% CI: [0.58] - [(1.39], p = 0.63, I2=0.00%). Wound dehiscence was marginally less common in the one miniplate group (OR=0.52, 95% CI: [0.28] - [0.98], p = 0.04, I2=54.34%). The probability of scarring formation (OR=0.13, 95% CI: [0.05] - [0.32], p = 0.00, I2=0.00%) and hardware failure (OR=0.36, 95% CI [0.21] - [0.62], p = 0.00, I2=29.33%) were statistically significantly higher in the two miniplates arm. CONCLUSION One miniplate fixation and two miniplates fixation of mandibular angle fractures have similar results regarding post operative infection, malocclusion, neurosensory dysfunction and pseudoarthrosis formation while wound dehiscence, hardware failure and scarring seem to be more common when two miniplates are used as a fixation technique.
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Affiliation(s)
- Evangelos N Vitkos
- Department of General Surgery, General Hospital of Katerini, Katerini, Greece.
| | | | - Periklis Dimasis
- Department of General Surgery, General Hospital of Katerini, Katerini, Greece
| | - Christian Weissinger
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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19
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Scharf C, Brancaccio G, Di Stefani A, Fargnoli MC, Kittler H, Kyrgidis A, Lallas A, Longo C, Malvehy J, Moscarella E, Peris K, Piana S, Puig S, Thomas L, Argenziano G. THE ASSOCIATION BETWEEN LOCKDOWNS DURING THE COVID-19 PANDEMIC AND MELANOMA DIAGNOSIS: A MULTICENTER RETROSPECTIVE STUDY FROM EUROPE. J Am Acad Dermatol 2022; 87:648-649. [PMID: 35588928 PMCID: PMC9110066 DOI: 10.1016/j.jaad.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022]
Affiliation(s)
- C Scharf
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy.
| | - G Brancaccio
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | - A Di Stefani
- Dermatologia, Università Cattolica e Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Austria
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Medical School, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E Moscarella
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | - K Peris
- Dermatologia, Università Cattolica e Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy
| | - S Piana
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - L Thomas
- Centre Hospitalier Lyon Sud, Lyon, France; Lyons France, Lyon 1 University, Lyon, France; Lyons France and Lyons Cancer research center UMR INSERM U1052 - CNRS5286 - UCBL1, Lyons France
| | - G Argenziano
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
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20
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Errichetti E, Apalla Z, Geller S, Sławińska M, Kyrgidis A, Kaminska‐Winciorek G, Jurakic Toncic R, Bobos M, Rados J, Ledic Drvar D, Ceovic R, Akay BN, Piccolo V, Myskowski P, Vitiello P, Russo T, Argenziano G, Sokołowska‐Wojdyło M, Sobjanek M, Stoikovic‐Filipovic J, Longo C, Pellacani G, Stinco G, Lallas A. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2022; 36:1045-1053. [DOI: 10.1111/jdv.18078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology Department of Medicine University of Udine Udine Italy
| | - Zoe Apalla
- Second Department of Dermatology Aristotle University Thessaloniki Greece
| | - Shamir Geller
- Dermatology Service Department of Medicine Memorial Sloan Kettering Cancer Center New York USA
- Division of Dermatology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology Faculty of Medicine Medical University of Gdańsk Poland
| | - Athanassios Kyrgidis
- Department of Oral & Maxillofacial surgery Aristotle University Thessaloniki Greece
| | - Grażyna Kaminska‐Winciorek
- Department of Bone Marrow Transplantation and Onco‐Hematology Maria Sklodowska‐Curie National Research Institute of Oncology (MSCNRIO) Gliwice Poland
| | - Ruzica Jurakic Toncic
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Mattheos Bobos
- Department of Biomedical Sciences School of Health Sciences International Hellenic University Alexandrian Campus Sindos, Thessaloniki Greece
| | - Jaka Rados
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Daniela Ledic Drvar
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Romana Ceovic
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | | | | | - Patricia Myskowski
- Dermatology Service Department of Medicine Memorial Sloan Kettering Cancer Center New York USA
| | | | - Teresa Russo
- Dermatology Unit University of Campania Naples Italy
| | | | | | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology Faculty of Medicine Medical University of Gdańsk Poland
| | - Jelena Stoikovic‐Filipovic
- Clinic of Dermatology and Venereology Clinical Center of Serbia Department of Dermatology Faculty of Medicine University of Belgrade Belgrade Serbia
| | - Caterina Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Azienda Sanitaria Locale IRCCS di Reggio Emilia Centro Oncologico ad Alta Tecnologia Diagnostica‐Dermatologia Reggio Emilia Italy
| | - Giovanni Pellacani
- Dermatology Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences University La Sapienza Rome
| | - Giuseppe Stinco
- Institute of Dermatology Department of Medicine University of Udine Udine Italy
| | - Aimilios Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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21
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Apalla Z, Lallas A, Mastraftsi S, Giannoukos A, Noukari D, Goula M, Kalantzi P, Zapridou M, Lallas K, Kyrgidis A, Lazaridou E, Stratigos A, Sidiropoulos T, Nicolaidou E. Impact of COVID-19 pandemic on STIs in Greece. Sex Transm Infect 2022; 98:70. [PMID: 33653880 PMCID: PMC7931207 DOI: 10.1136/sextrans-2021-054965] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Affiliation(s)
- Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Styliani Mastraftsi
- 1st Department of Dermatology and Venereology, Andreas Syggros University Hospital of Athens, Athens, Greece
| | - Anastassios Giannoukos
- 1st Department of Dermatology and Venereology, Andreas Syggros University Hospital of Athens, Athens, Greece
| | - Despoina Noukari
- State Dermatology Department, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Maria Goula
- State Dermatology Department, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Polychronia Kalantzi
- State Dermatology Department, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Maria Zapridou
- State Dermatology Department, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Konstantinos Lallas
- First Dermatology Department, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Athanassios Kyrgidis
- Department of Clinical Pharmacology, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, Andreas Syggros University Hospital of Athens, Athens, Greece
| | - Theodoros Sidiropoulos
- State Dermatology Department, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Andreas Syggros University Hospital of Athens, Athens, Greece
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22
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Kyrgidis A, Tilaveridis I, Stefanidou A, Tilaveridis S, Tilaveridou S, Zouloumis L. Foreign bodies of dental iatrogenic origin displaced in the maxillary sinus - A safety and efficacy analysis of a retrospective study. Ann Maxillofac Surg 2022; 12:33-38. [PMID: 36199448 PMCID: PMC9527830 DOI: 10.4103/ams.ams_190_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/20/2022] [Accepted: 02/04/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction: Foreign bodies (FB) of the paranasal sinuses are an uncommon clinical entities with the maxillary sinuses being those most frequently affected. According to the literature, 60% of paranasal sinus FB are of iatrogenic origin, while 25% are of traumatic origin. This article aims to present an iatrogenic origin series of cases of FB displaced or projecting into the maxillary sinus. Materials and Methods: In this retrospective study, the presence of the foreign body was revealed with radiologic methods and confirmed during the operation with macroscopic or later with histopathologic examination. All cases were treated with osteoplasty with vascularised pedicled bone flap or through minimally invasive intraoral procedure. Results: A total of 27 patients were included in our study, 14 men and 13 women. The age range was 18–65 years with mean age of 46.14 (standard deviation = 10.35) years. Foreign body was displaced fragments of teeth in 11 patients (40.27%), complete teeth in four patients (14.81%), dental implants in five patients (18.51%), dental impression material in 2 cases (7,40%), gutta percha cone in two patients (7.40%), endodontic sealer associated with aspergillosis in two patients (7.40%), and dental burr in one patient (3.7%). The time between dental foreign body displacement and the surgical intervention for its removal was critical for the occurrence of sinusitis. All operated patients remained asymptomatic during a follow-up of at least 1 year. Discussion: Prompt intervention for removal of FB eliminates the risk for chronic inflammation of the affected maxillary sinus and reduces the odds for sequelae.
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23
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Apalla Z, Fotiadou C, Emvalomati A, Patsatsi A, Trakatelli M, Trigoni A, Kyrgidis A, Trakatelli C, Papazisis G, Lallas A, Droggoula O, Giannakaki MM, Oflidou V, Siskou S, Boziou M, Karydi K, Daponte A, Kemanetzi C, Tsatsou F, Kyrmanidou E, Lazaridou E. The impact of COVID-19 pandemic on psoriasis patients in northern Greece. Dermatol Ther 2021; 35:e15244. [PMID: 34862701 DOI: 10.1111/dth.15244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/19/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Zoe Apalla
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Christina Fotiadou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Anastasia Emvalomati
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Myrto Trakatelli
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Anastasia Trigoni
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Maxillofacial Surgery Department, Papanikolaou General Hospital of Thessaloniki, Greece
| | - Christina Trakatelli
- Department of Internal Medicine, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Georgios Papazisis
- Pharmacology Laboratory, Faculty of Medicine, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, Faculty of Medicine, Aristotle University, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Ourania Droggoula
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Melpomeni-Maria Giannakaki
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Valentina Oflidou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Styliani Siskou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Maria Boziou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Kalliopi Karydi
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Athena Daponte
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Christina Kemanetzi
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Fragkiski Tsatsou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Eirini Kyrmanidou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, Faculty of Medicine, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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24
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Lallas A, Martínez G, Arceu M, Kyrgidis A, Liopyris K, Brancaccio G, Longo C, Errichetti E, Sgouros D, Papageorgiou C, Fotiadou C, Siskou S, Manoli SM, Sotiriou E, Ioannides D, Katoulis A, Lazaridou E, Todorovska V, Argenziano G, Apalla Z. Clinical and dermatoscopic predictors of squamous cell carcinoma of the lips: a case-control, multicentric study. J Eur Acad Dermatol Venereol 2021; 36:222-227. [PMID: 34743367 DOI: 10.1111/jdv.17790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/29/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Squamous cell carcinoma of the lip accounts for 20% of all oral carcinomas. Its diagnosis may be challenging because it clinically resembles actinic cheilitis and inflammatory lesions of the lips. OBJECTIVES To determine clinical and dermatoscopic predictors of squamous cell carcinoma of the lip vs. other lip lesions. METHODS Multicentre retrospective morphological study, including histologically confirmed cases of squamous cell carcinoma of the lip and controls consisting of actinic cheilitis and inflammatory lesions of the lips. Clinical and dermatoscopic images were evaluated for the presence of predefined criteria. Crude and adjusted odds ratios and corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression respectively. RESULTS A total of 177 lip lesions were evaluated, 107 (60.5%) were squamous cell carcinomas and 70 (39.5%) were controls. The most frequent dermatoscopic criteria of lip squamous cell carcinoma were scales (100%), white halos (87.3%) and ulceration (79.4%). The majority of squamous cell carcinomas displayed polymorphic vessels (60.8%), with linear (68.6%) and hairpin (67.6%) being the most frequent types. Multivariate logistic regression analysis showed that clinical predictors of lip squamous cell carcinoma were exophytic appearance and clinical hyperkeratosis, with 43-fold and 6-fold higher probability respectively. White clods and ulceration in dermoscopy presented a 6-fold and 4-fold increased risk for squamous cell carcinoma respectively. CONCLUSIONS A scaly lesion with exophytic growth, dermatoscopically displaying white clods, ulceration and linear and hairpin vessels is very likely a squamous cell carcinoma of the lip.
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Affiliation(s)
- A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Martínez
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - M Arceu
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - K Liopyris
- First Department of Dermatology, Andreas Syggros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - G Brancaccio
- Dermatology Department, University of Campania, Naples, Italy
| | - C Longo
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - D Sgouros
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Papageorgiou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Siskou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S M Manoli
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Katoulis
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - G Argenziano
- Dermatology Department, University of Campania, Naples, Italy
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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25
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Lallas A, Kyrgidis A, Manoli SM, Papageorgiou C, Lallas K, Sotiriou E, Vakirlis E, Sidiropoulos T, Ioannides D, Apalla Z. Delayed skin cancer diagnosis in 2020 because of the COVID-19-related restrictions: Data from an institutional registry. J Am Acad Dermatol 2021; 85:721-723. [PMID: 34052332 PMCID: PMC8156834 DOI: 10.1016/j.jaad.2021.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece; DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Sofia-Magdalini Manoli
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece; DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece; Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Konstantinos Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Elena Sotiriou
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Theodoros Sidiropoulos
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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26
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Lallas A, Moscarella E, Kittler H, Longo C, Thomas L, Zalaudek I, Kyrgidis A, Manoli SM, di Meo N, Papageorgiou C, Apalla Z, Argenziano G. Real-world experience of off-label use of imiquimod 5% as an adjuvant therapy after surgery or as a monotherapy for lentigo maligna. Br J Dermatol 2021; 185:675-677. [PMID: 33894006 DOI: 10.1111/bjd.20407] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 01/17/2023]
Affiliation(s)
- A Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - E Moscarella
- Dermatology Unit, University of Campania, Naples, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unita Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - L Thomas
- Department of Dermatology, Hospital Lyon Sud, France.,Lyon 1 University, Lyon, France.,Lyons cancer research center INSERM U1052-CNRS UMR5286, France
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Italy
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Greece
| | - S M Manoli
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - N di Meo
- Department of Dermatology, University of Trieste, Italy
| | - C Papageorgiou
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.,Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Z Apalla
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.,Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
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27
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Apalla Z, Spyridis I, Kyrgidis A, Lazaridou E, Kyriakou A, Fotiadou C, Pikou O, Sotiriou E, Vakirlis E, Papageorgiou C, Delli F, Moutsoudis A, Manoli SM, Ioannides D, Lallas A. Vismodegib in real-life clinical settings: A multicenter, longitudinal cohort providing long-term data on efficacy and safety. J Am Acad Dermatol 2020; 85:1589-1592. [PMID: 33253837 DOI: 10.1016/j.jaad.2020.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Greece.
| | - Ioannis Spyridis
- First Dermatology Department, Aristotle University of Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Clinical Pharmacology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | | | | | - Christina Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, Greece
| | - Olga Pikou
- Second Dermatology Department, Aristotle University of Thessaloniki, Greece
| | - Elena Sotiriou
- Second Dermatology Department, Aristotle University of Thessaloniki, Greece
| | | | | | - Florentina Delli
- State Dermatology Department, Hippokratio General Hospital of Thessaloniki, Greece
| | - Andreas Moutsoudis
- First Dermatology Department, Aristotle University of Thessaloniki, Greece
| | | | | | - Aimilios Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Greece
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28
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Apalla Z, Papadimitriou I, Iordanidis D, Errichetti E, Kyrgidis A, Rakowska A, Sotiriou E, Vakirlis E, Bakirtzi A, Liopyris K, Fotiadou C, Lazaridou E, Lallas A, Ioannidis D. The dermatoscopic spectrum of cutaneous lupus erythematosus: A retrospective analysis by clinical subtype with clinicopathological correlation. Dermatol Ther 2020; 33:e14514. [PMID: 33166029 DOI: 10.1111/dth.14514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/04/2020] [Indexed: 11/27/2022]
Abstract
The skin is the most common organ of involvement during the course of lupus erythematosus (LE). The literature data concerning the dermatoscopic patterns of the different clinical variants of cutaneous LE (CLE), namely chronic (CCLE), subacute (SCLE), and acute (ACLE), are scarce. To determine the dermatoscopic spectrum of CLE and to correlate the dermatoscopic features with the histological findings. This was a retrospective, observational, multicenter, cohort study. We evaluated the dermatoscopic features in a cohort of patients diagnosed with CLE. Furthermore, we investigated their frequency per clinical subtype and correlated them with the anatomic alterations. We included 79 patients. The most prevalent dermatoscopic features of CCLE included follicular plugs (86.4%, P < .01), patchy distribution (75%, P = .1) of mostly linear curved vessels (56.8%, P = .8), white scales (68.2%, P < .01), and structureless white color (68.2%, P < .01). The most common criteria of SCLE were patchy distribution (90%, P = .1) of mostly linear curved vessels (53.3%, P = .8) and fine white scales (60%, P < .01), while ACLE was characterized by erythema (100%, P < .05) and patchy distribution (100%, P = .1) of mostly dotted vessels (60%, P = .4). Follicular plugs/rosettes in dermatoscopy strongly correlated with follicular plugs in histology (rho = 0.919). Hyperkeratosis significantly correlated with white (rho = 0.644) and yellow/brown scales (rho = 0.225), telangiectasia with linear curved vessels (rho = 0.321) and white color with dermal fibrosis (rho = 0.623). Depending on CLE subtype, distinct dermatoscopic patterns are recognized. In CLE there is a high correlation between certain dermatoscopic criteria and the underneath anatomic alteration.
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Affiliation(s)
- Zoe Apalla
- Second Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ilias Papadimitriou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Iordanidis
- State Dermatology Department, Hippokratio General Hospital, Thessaloniki, Greece
| | | | - Athanassios Kyrgidis
- Department of Clinical Pharmacology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Elena Sotiriou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Bakirtzi
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Christina Fotiadou
- Second Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Demetrios Ioannidis
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sgouros D, Lallas A, Kittler H, Zarras A, Kyrgidis A, Papageorgiou C, Puig S, Scope A, Argenziano G, Zalaudek I, Pizzichetta MA, Marghoob A, Liopyris K, Malvehy J, Oikonomou C, Flórez A, Braun R, Cabo H, Nazzaro G, Lanssens S, Menzies S, Paoli J, Kaminska-Winciorek G, Longo C, Katoulis A, Apalla Z, Ioannides D, Thomas L, Tromme I, Ogata D, Desinioti C, Geller A, Stratigos A. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2020; 34:2541-2547. [PMID: 32654237 DOI: 10.1111/jdv.16815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. OBJECTIVE To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. METHODS Retrospective, morphological case-control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. RESULTS Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. LIMITATIONS Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. CONCLUSIONS Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours.
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Affiliation(s)
- D Sgouros
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Lallas
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Zarras
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Kyrgidis
- Department of Clinical Pharmacology, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Argenziano
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - M A Pizzichetta
- Department of Dermatology, University of Trieste, Trieste, Italy.,Division of Medical Oncology - Preventive Oncology, National Cancer Institute, Aviano, Italy
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - K Liopyris
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.,Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - C Oikonomou
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Flórez
- Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain
| | - R Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - H Cabo
- Dermatology Institute of Medical Reserch, University of Buenos Aires, Buenos Aires, Argentina
| | - G Nazzaro
- Dermatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - S Lanssens
- Private practice Dermatology Maldegem, Maldegem, Belgium
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Kaminska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Skłodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Gliwice, Poland
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Katoulis
- 2nd Department of Dermatology-Venereology, "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - D Ioannides
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - I Tromme
- Department of Dermatology, King Albert II Institute, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - D Ogata
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - C Desinioti
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Geller
- Department of Social and Behavioral Sciences, Harvard TH School of Public Health, Boston, MA, USA
| | - A Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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30
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Cuevas RG, Villani A, Apalla Z, Kyrgidis A, Bagolini LP, Papageorgiou C, Manoli MS, Bobos M, Moutsoudis A, Liopyris K, Lazaridou E, Sotiriou E, Vakirlis E, Ioannides D, Lallas A. Dermoscopic predictors of melanoma arising in small- and medium-sized congenital nevi. J Am Acad Dermatol 2020; 84:1703-1705. [PMID: 32763328 DOI: 10.1016/j.jaad.2020.07.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/09/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Alessia Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
| | - Zoe Apalla
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | | | | | - Mattheos Bobos
- Microdiagnostics Pathology Laboratory, Thessaloniki, Greece
| | - Andreas Moutsoudis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Elizabeth Lazaridou
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Elena Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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31
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Errichetti E, Zelin E, Pinzani C, Kyrgidis A, Lallas A, Stinco G. Dermoscopic and Clinical Response Predictor Factors in Nonsegmental Vitiligo Treated with Narrowband Ultraviolet B Phototherapy: A Prospective Observational Study. Dermatol Ther (Heidelb) 2020; 10:1089-1098. [PMID: 32749663 PMCID: PMC7477062 DOI: 10.1007/s13555-020-00431-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction Few data on possible local factors that can influence the achievement of response in nonsegmental vitiligo (NSV) treated with narrowband ultraviolet B (Nb-UVB) phototherapy are available. Our objective is to evaluate possible correlations between therapeutic outcomes and dermoscopic and local (lesional) clinical findings of vitiligous lesions undergoing Nb-UVB phototherapy to find positive and/or negative response predictor factors to such treatment. Methods For each target patch, we calculated the extension area using a computer-aided method and assessed dermoscopic and local (lesional) clinical findings at baseline. After 30 phototherapy sessions (twice weekly), surface area of the lesions was reevaluated to assess clinical improvement, correlating the therapeutic outcome with initial clinical and dermoscopic features. Results A total of 70 lesions were finally included in the study. At the end of therapy, 18 patches (25.7%) achieved improvement, and the presence of perifollicular pigmentation on baseline dermoscopic examination was found to be associated with a 12-fold higher probability of having a positive therapeutic outcome. Similarly, face localization was also correlated with clinical amelioration, with a sevenfold higher probability for improvement. No association (p > 0.05) between therapeutic outcomes (either good or poor) and other dermoscopic or local clinical variables (including leukotrichia) was observed. Conclusions Therapeutic response of vitiligo to Nb-UVB phototherapy may be positively affected by local features of the lesions, i.e., face localization and presence of perifollicular pigmentation on baseline dermoscopic examination, which might be considered as positive response predictor factors to optimize treatment of vitiligo.
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Affiliation(s)
- Enzo Errichetti
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy.
| | - Enrico Zelin
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Caterina Pinzani
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - Athanassios Kyrgidis
- Department of Otolaryngology-Head and Neck Surgery, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Giuseppe Stinco
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
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32
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Pampena R, Manfreda V, Kyrgidis A, Lai M, Borsari S, Benati E, Lombardi M, Bianchi L, Zalaudek I, Moscarella E, Lallas A, Argenziano G, Pellacani G, Longo C. Digital dermoscopic changes during follow-up of de-novo and nevus-associated melanoma: a cohort study. Int J Dermatol 2020; 59:813-821. [PMID: 32406113 DOI: 10.1111/ijd.14918] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/29/2020] [Accepted: 04/13/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Nevus-associated melanoma (NAM) has been regarded as a distinct biological entity from de-novo melanoma (DNM); however, static dermoscopy often fails in differentiating these entities. Digital dermoscopic monitoring allows to identify dynamic changes occurring during follow-up; this may improve diagnostic accuracy and potentially our knowledge on NAM biology. We aimed to define main independent factors associated with NAM diagnosis and those influencing follow-up time in a population of melanomas excised at follow-up. METHODS A cohort of melanomas excised at follow-up was retrospectively and consecutively selected. NAMs and DNMs were compared according to baseline features and main dermoscopic changes occurring during follow-up. Univariate and multivariable logistic and Cox's regression analysis were performed to respectively define factors associated with NAM diagnosis and those influencing the risk for excision. RESULTS Eighty-six melanomas were enrolled, of which 21 (24.4%) were nevus-associated. During follow-up NAMs mainly underwent atypical network modifications (47.6%), followed by inverse network (28.6%) and dermoscopic island (23.8%) worsening or appearance. DNMs were also mainly characterized by atypical network modifications (47.7%), however, a significant proportion of cases underwent irregular pigmentation/dots/globules or regression changes (29.2%), which were rarely seen among NAMs. Furthermore, both multivariable logistic and Cox's regression analysis demonstrated a significant association between NAM and a longer follow-up. CONCLUSIONS We demonstrated that among melanomas excised at follow-up, different patterns of dermoscopic changes may be found between NAMs and DNMs. This finding, together with the association of NAM with a longer follow-up time, supports the hypothesis of different biological behavior of these two entities.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valeria Manfreda
- Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy
| | | | - Michela Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Borsari
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Benati
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mara Lombardi
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy
| | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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33
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Lekkas D, Ioannides D, Lazaridou E, Lallas A, Apalla Z, Vakirlis E, Johr R, Errichetti E, Kyrgidis A, Sotiriou E. Dermatoscopy of tinea corporis. J Eur Acad Dermatol Venereol 2020; 34:e278-e280. [DOI: 10.1111/jdv.16277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D. Lekkas
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - D. Ioannides
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - E. Lazaridou
- 2nd Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Lallas
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Z. Apalla
- State Clinic of Dermatology Hippokration General Hospital Thessaloniki Greece
| | - E. Vakirlis
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - R. Johr
- University of Miami Miller School of Medicine Miami FL USA
| | - E. Errichetti
- Institute of Dermatology “Santa Maria della Misericordia” University Hospital Udine Italy
| | - A. Kyrgidis
- Department of Clinical Pharmacology Aristotle University Thessaloniki Greece
| | - E. Sotiriou
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
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34
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Lallas A, Apalla Z, Kyrgidis A, Papageorgiou C, Boukovinas I, Bobos M, Efthimiopoulos G, Nikolaidou C, Moutsoudis A, Gkentsidi T, Lallas K, Lazaridou E, Sotiriou E, Vakirlis E, Ioannides D. Second primary melanomas in a cohort of 977 melanoma patients within the first 5 years of monitoring. J Am Acad Dermatol 2020; 82:398-406. [DOI: 10.1016/j.jaad.2019.08.074] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/15/2019] [Accepted: 08/28/2019] [Indexed: 12/14/2022]
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35
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Longo C, Pampena R, Lallas A, Kyrgidis A, Stratigos A, Peris K, Garbe C, Pellacani G. Adjuvant therapy for cutaneous melanoma: a systematic review and network meta‐analysis of new therapies. J Eur Acad Dermatol Venereol 2020; 34:956-966. [DOI: 10.1111/jdv.16074] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/30/2019] [Indexed: 12/19/2022]
Affiliation(s)
- C. Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Reggio Emilia Italy
| | - R. Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Reggio Emilia Italy
| | - A. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Kyrgidis
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Stratigos
- First Department of Dermatology and Venereology National and Kapodistrian University of Athens, A. Sygros Hospital Athens Greece
| | - K. Peris
- Institute of Dermatology Catholic University Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - C. Garbe
- Center of Dermato‐oncology University Department of Dermatology Eberhard Karls University Tuebingen Germany
| | - G. Pellacani
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
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Kyrgidis A, Yavropoulou MP, Zikos P, Lagoudaki R, Tilaveridis J, Zouloumis L. Changes in peripheral monocyte populations 48-72 hours after subcutaneous denosumab administration in women with osteoporosis. J Musculoskelet Neuronal Interact 2020; 20:339-346. [PMID: 32877971 PMCID: PMC7493451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To examine the effect of denosumab administration in the peripheral blood white cell population, to further elucidate a plausible pathophysiological link between denosumab and osteonecrosis of the jaw. METHODS Thirty women with osteoporosis, after denosumab treatment were included. Peripheral blood samples were obtained prior to and 48-72 hours following denosumab administration. Flow cytometry gated at the monocyte population for CD14/CD23/CD123/CD16 stainings were performed. RESULTS We were able to record a number of changes in the monocyte populations between baseline and after denosumab administration. Most importantly, in the monocyte populations we were able to detect statistically significant increased populations of CD14+/CD23+ (p=0.044), CD14-/CD23+ (p=0.044), CD14+/CD123+ (p=0.011), CD14+/CD123- (p=0.011) and CD14-/CD16+ (p=0.028). In contrast, statistically significant decreased populations of CD14-/CD123+ (p=0.034), CD14+/CD16+ (p=0.037) and CD14+/CD16- (p=0.014) were detected. CONCLUSIONS Our results provide evidence supporting the hypothesis that denosumab administration modifies the monocyte mediated immune response in a manner similar to that of bisphosphonates. This may partly explain the trivial immunity changes recorded with denosumab.
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Affiliation(s)
- Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece,Department of Pharmacology, Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria P. Yavropoulou
- Endocrinology Unit 1st Propaedeutic Department of Internal Medicine, LAIKO General Hospital of Athens, National and Kapodistrian University of Athens, UOA, Athens, Greece
| | - Petros Zikos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roza Lagoudaki
- Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece
| | - Jannis Tilaveridis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Zouloumis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Pampena R, Raucci M, Mirra M, Lombardi M, Piana S, Kyrgidis A, Peccerillo F, Paganelli A, Garbarino F, Pellacani G, Longo C. The role of ultrasound examination for early identification of lymph-node metastasis of cutaneous squamous cell carcinoma: results from a single institutional center. Ital J Dermatol Venerol 2019. [PMID: 31804052 DOI: 10.23736/s0392-0488.19.06487-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Metastasis from cutaneous squamous cell carcinoma (cSCC) mainly involve the regional nodal basin, with an incidence ranging from 2-4% until 15% in case of high-risk tumors. When dealing with high-risk cSCC, ultrasound examination is recommended every 3-4 months during follow-up. We aimed to determine the role of US examination in the early diagnosis of nodal metastasis from cSCC. METHODS We conducted a retrospective cohort study enrolling consecutive cases of histopathologically verified cSCCs from January 2007 to March 2018. All the enrolled cases were followed for at least one year and all cases of histopathologically verified metastasis were registered. We also reported if ultrasound of the regional basin was performed between the primary diagnosis and metastasis and how the latter was identified, through ultrasounds or clinically. A Kaplan-Meier survival analysis was conducted on patients undergoing ultrasounds during follow-up. RESULTS A total of 1881 cases, belonging to 1441 patients were included. Thirty-one cases of nodal metastasis diagnosed after the primary tumor, in as many patients, were identified. All of the selected metastasis derived from high-risk primary cSCCs. Only in 19 cases ultrasound examination was performed during follow-up; of these, 10 were diagnosed through ultrasounds and 9 clinically. Survival analysis demonstrated that the time interval between primary tumor and metastasis was significantly lower for patients with metastasis diagnosed by ultrasounds than clinically (P=0.036). CONCLUSIONS Our study highlighted the need to optimize the use of nodal ultrasound examination for high-risk cSCCs in order to early detect metastasis.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy -
| | - Margherita Raucci
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Marica Mirra
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Mara Lombardi
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Simonetta Piana
- Unit of Pathology, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Alessia Paganelli
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Garbarino
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy.,Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Pampena R, Raucci M, Mirra M, Lombardi M, Piana S, Kyrgidis A, Peccerillo F, Paganelli A, Garbarino F, Pellacani G, Longo C. The role of ultrasound examination for early identification of lymph-node metastasis of cutaneous squamous cell carcinoma: results from a single institutional center. Ital J Dermatol Venerol 2019; 156:479-483. [PMID: 31804052 DOI: 10.23736/s2784-8671.19.06487-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Metastasis from cutaneous squamous cell carcinoma (cSCC) mainly involve the regional nodal basin, with an incidence ranging from 2-4% until 15% in case of high-risk tumors. When dealing with high-risk cSCC, ultrasound examination is recommended every 3-4 months during follow-up. We aimed to determine the role of US examination in the early diagnosis of nodal metastasis from cSCC. METHODS We conducted a retrospective cohort study enrolling consecutive cases of histopathologically verified cSCCs from January 2007 to March 2018. All the enrolled cases were followed for at least one year and all cases of histopathologically verified metastasis were registered. We also reported if ultrasound of the regional basin was performed between the primary diagnosis and metastasis and how the latter was identified, through ultrasounds or clinically. A Kaplan-Meier survival analysis was conducted on patients undergoing ultrasounds during follow-up. RESULTS A total of 1881 cases, belonging to 1441 patients were included. Thirty-one cases of nodal metastasis diagnosed after the primary tumor, in as many patients, were identified. All of the selected metastasis derived from high-risk primary cSCCs. Only in 19 cases ultrasound examination was performed during follow-up; of these, 10 were diagnosed through ultrasounds and 9 clinically. Survival analysis demonstrated that the time interval between primary tumor and metastasis was significantly lower for patients with metastasis diagnosed by ultrasounds than clinically (P=0.036). CONCLUSIONS Our study highlighted the need to optimize the use of nodal ultrasound examination for high-risk cSCCs in order to early detect metastasis.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy -
| | - Margherita Raucci
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Marica Mirra
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Mara Lombardi
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy
| | - Simonetta Piana
- Unit of Pathology, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Alessia Paganelli
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Garbarino
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, AUSL - IRCCS Reggio Emilia, Reggio Emilia Italy.,Unit of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Kyrgidis A, Becker M, Zampeli V, Fauger A, Sayag M, Zouboulis C. Multimodal Clinical Imaging Assessment of the Outcome in Mild-to-Moderate Acne: A Prospective Study. Dermatology 2019; 235:471-477. [DOI: 10.1159/000501272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/31/2019] [Indexed: 11/19/2022] Open
Abstract
Background: The quality of outcome assessment in acne studies has been either subjective/insufficient or time consuming through the ordinary lesion counting. Objective: To evaluate the application of multimodal clinical imaging (MCI), a combination of imaging technology and computation, in the assessment of acne lesions in a clinical study setting. Methods: A prospective, monocentric, single-group open study designed to evaluate the efficacy and tolerance of a cosmetic product (IP/SG) in subjects with mild-to-moderate facial acne by classical clinical counting (CCC) – change in the total/inflammatory/noninflammatory acne lesion number compared with baseline (D0) – Investigator Global Assessment (IGA) and self-reported outcomes. Concomitantly, MCI was administered. The study was performed for 12 weeks (D84) with a 4-week follow-up (D112). Results: Mean age of patients (n = 49) was 18.2 ± 3.7 years (range 13–25). The mean acne duration was 3.8 ± 2.8 years. The total number of lesions did not differ significantly between D0/D84 by both CCC and MCI. However, the Cardiff Acne Disability Index (CADI) and uncomfortable feeling improved at D28/D0, the perception of oily skin improved at D14/D0, and the perception of sticky skin improved from D28/D0 to D56/D0. Deterioration was detected between D84/D0 and D112/D0, namely after product discontinuation. Interestingly, a change in trend was recorded for acne lesions at D14/D0 by MCI but not by CCC. Conclusion: MCI, applied for the first time in a small clinical study setting, is at least as reliable as CCC and may allow for a sensitive longitudinal evaluation of single acne lesions and their response to products, especially in conditions where clinical evaluation reaches its limits.
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Nikolakis G, Kyrgidis A, Zouboulis CC. Is There a Role for Antiandrogen Therapy for Hidradenitis Suppurativa? A Systematic Review of Published Data. Am J Clin Dermatol 2019; 20:503-513. [PMID: 31073704 DOI: 10.1007/s40257-019-00442-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hidradenitis suppurativa/acne inversa is a disease with deep-seated chronic painful nodules, abscesses, and draining sinus tracts, which manifests on the apocrine gland-rich skin areas of the body. Observational findings demonstrate that the disease usually appears after puberty, exhibits pre-menstrual flares in women, improves in pregnancy, and worsens post-partum, which indicates a role of hormones and particularly of androgens in its pathophysiology. Because increased androgen levels in serum have not been widely reported, an end-organ androgen hypersensitivity has been postulated. OBJECTIVE The aim of this systematic review was to identify and present evidence for antiandrogen therapeutic options for the treatment of hidradenitis suppurativa/acne inversa. METHODS A literature search was conducted in different medical electronic databases using the keywords "hidradenitis", "suppurativa", "acne inversa", and "antiandrogen" on 1 December, 2018. The main therapeutic options were subsequently used as separate keywords with the disease terms in a separate search. RESULTS The main therapeutic options yielded were cyproterone acetate, spironolactone, finasteride, and metformin. One randomized controlled crossover trial and seven case series were identified following use of a standard extraction form for eligibility. CONCLUSION The existing studies do not allow a robust evidence-based recommendation for the use of antiandrogens in the treatment of hidradenitis suppurativa/acne inversa. Further randomized controlled trials are needed to define the role of hormonal treatment as an alternative or concomitant therapy together with antibiotics or biologics.
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Apalla Z, Errichetti E, Kyrgidis A, Stolz W, Puig S, Malvehy J, Zalaudek I, Moscarella E, Longo C, Blum A, Lanssens S, Savoia F, Tschandl P, Kittler H, Sinz C, Stinco G, Argenziano G, Lazaridou E, Lallas A. Dermoscopic features of mammary Paget’s disease: a retrospective case‐control study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2019; 33:1892-1898. [DOI: 10.1111/jdv.15732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Z. Apalla
- State Dermatology Department Hippokratio General Hospital Thessaloniki Greece
| | - E. Errichetti
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - A. Kyrgidis
- Department of Clinical Pharmacology Aristotle University of Thessaloniki Thessaloniki Greece
| | - W. Stolz
- Clinic of Dermatology II Munich Hospital Munich Germany
| | - S. Puig
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - J. Malvehy
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - I. Zalaudek
- Department of Dermatology University of Trieste Trieste Italy
| | - E. Moscarella
- Dermatology Unit University of Campania Naples Italy
| | - C. Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Centro Oncologico ad Alta Tecnologia Diagnostica‐Dermatologia Reggio Emilia Italy
| | - A. Blum
- Public, Private and Teaching Practice of Dermatology Konstanz Germany
| | | | - F. Savoia
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - P. Tschandl
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - H. Kittler
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - C. Sinz
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - G. Stinco
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - G. Argenziano
- Dermatology Unit University of Campania Naples Italy
| | - E. Lazaridou
- Second Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Lallas
- First Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
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Papageorgiou C, Apalla Z, Bobos M, Gkentsidi T, Kyrgidis A, Lallas K, Manoli SM, Moutsoudis A, Nikolaidou C, Spyridis I, Lallas A. Dermoscopy of Spitz/Reed naevi and management. GIORN ITAL DERMAT V 2019; 154:457-465. [DOI: 10.23736/s0392-0488.19.06294-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lallas A, Longo C, Manfredini M, Benati E, Babino G, Chinazzo C, Apalla Z, Papageorgiou C, Moscarella E, Kyrgidis A, Argenziano G. Accuracy of Dermoscopic Criteria for the Diagnosis of Melanoma In Situ. JAMA Dermatol 2019; 154:414-419. [PMID: 29466542 DOI: 10.1001/jamadermatol.2017.6447] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The accuracy of melanoma-specific dermoscopic criteria has been tested mainly in studies including invasive tumors. Scarce evidence exists on the usefulness of these criteria for the diagnosis of melanoma in situ (MIS). Objective To investigate the diagnostic accuracy of dermoscopic criteria for the diagnosis of MIS. Design, Setting, and Participants A diagnostic accuracy study with retrospective patient enrollment was conducted in 3 centers specializing in skin cancer diagnosis and management. A total of 1285 individuals with histopathologically diagnosed MIS or other flat, pigmented skin tumors that were histopathologically diagnosed or monitored for at least 1 year were included. Dermoscopic images of MIS and other flat, pigmented skin tumors were evaluated by 3 independent investigators for the presence of predefined criteria. Evaluators were blinded to the clinic dermoscopic and histopathologic diagnosis. Main Outcomes and Measures Frequencies of dermoscopic criteria per diagnosis were calculated. Crude odds ratios, adjusted odds ratios, and corresponding 95% CIs were calculated by univariate and multivariate logistic regression, respectively. Results A total of 1285 patients were included in the study (642 [50%] male); mean age was 45.9 years (range, 9-91 years). Of a total of 1285 lesions obtained from these patients, 325 (25.3%) were MIS; 574 (44.7%) were nevi (312 [24.3%] excised and 262 [20.4%] not excised); 67 (5.2%) were seborrheic keratoses, solar lentigines, or lichen planus-like keratoses; 91 (7.1%) were pigmented superficial basal cell carcinomas; 26 (2.0%) were pigmented intraepithelial carcinomas; 100 (7.8%) were Reed nevi; and 102 (7.9%) were invasive melanomas with a Breslow thickness less than 0.75 mm. The most frequent dermoscopic criteria for MIS were regression (302 [92.9%]), atypical network (278 [85.5%]), and irregular dots and/or globules (163 [50.2%]). The multivariate analysis revealed 5 main positive dermoscopic indicators of MIS: atypical network (3.7-fold; 95% CI, 2.5-5.4), regression (4.7-fold; 95% CI, 2.8-8.1), irregular hyperpigmented areas (5.4-fold; 95% CI, 3.7-8.0), prominent skin markings (3.4-fold; 95% CI, 1.9-6.1), and angulated lines (2.2-fold; 95% CI, 1.2-4.1). When compared only with excised nevi, 2 of these criteria remained potent MIS indicators, namely, irregular hyperpigmented areas (4.3-fold; 95% CI, 2.7-6.8) and prominent skin markings (2.7-fold; 95% CI, 1.3-5.7). Conclusions and Relevance Clinicians should take into consideration the aforementioned dermoscopic indicators for the diagnosis of MIS.
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Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | | | - Elisa Benati
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Graziella Babino
- Department of Dermatology, University of Campania, Naples, Italy
| | - Chiara Chinazzo
- Department of Dermatology, University of Campania, Naples, Italy
| | - Zoe Apalla
- First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | - Athanassios Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
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Pampena R, Borsari S, Lai M, Benati E, Longhitano S, Mirra M, Kyrgidis A, Pellacani G, Longo C. External validation and comparison of four confocal microscopic scores for melanoma diagnosis on a retrospective series of highly suspicious melanocytic lesions. J Eur Acad Dermatol Venereol 2019; 33:1541-1546. [PMID: 30974506 DOI: 10.1111/jdv.15617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/15/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND In vivo reflectance confocal microscopy significantly improves melanoma diagnosis as compared to clinical/dermoscopic examination alone. Several confocal criteria have been described allowing to differentiate melanoma from nevi; by combining different criteria, three pure confocal scores (Pellacani 2005, Segura 2009 and Pellacani 2012) and one mixed dermoscopic/confocal score (Borsari 2018) were constructed. OBJECTIVE Our aim was to externally validate and compare the performance of these confocal scores. METHODS We retrospectively enrolled excised melanocytic lesions which underwent confocal examination in a 2-year period. Lesions located on the face and acral sites were excluded. Both dermoscopic and confocal criteria considered in the four scores were evaluated by experts. Subsequently, specificity and sensitivity levels for each score were calculated, together with the positive and negative predictive values and likelihood ratios; also, receiver operating characteristic curves were constructed. RESULTS A total of 389 patients with 422 lesions were retrospectively enrolled, of which 162 (38.4%) were melanomas and 260 (61.6%) were nevi (189 common and 71 Spitz/Reed nevi). The highest sensitivity levels were recorded for Segura 2009 with cut-off ≥-1 (92.0%), while Pellacani 2005 with cut-off ≥5 achieved the highest specificity (69.6%). The score by Borsari et al. showed the highest levels of positive and negative predictive values (59.8% and 91.5%) and likelihood ratios (2.4 and 0.1) as well as the highest area under the curve values (0.76; 95% CI 0.72-0.81; P < 0.001). CONCLUSIONS High levels of accuracy were found for each of the four considered scores. No differences were found among scores in confirming melanoma diagnosis when positive; however, the score by Borsari 2018 was the best in excluding melanoma diagnosis when negative.
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Affiliation(s)
- R Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Borsari
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Benati
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Longhitano
- Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - M Mirra
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Kyrgidis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Pellacani
- Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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Grimstad Ø, Tzellos T, Dufour DN, Bremnes Ø, Skoie IM, Snekvik I, Jarnaess E, Kyrgidis A, Ingvarsson G. Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG). J Eur Acad Dermatol Venereol 2019; 33:1164-1171. [PMID: 30451320 DOI: 10.1111/jdv.15353] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/23/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. OBJECTIVE The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. METHODS Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. RESULTS Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. CONCLUSIONS CO2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.
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Affiliation(s)
- Ø Grimstad
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - T Tzellos
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Dermatology, University Hospital of North Norway, Harstad, Norway
| | - D N Dufour
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
| | - Ø Bremnes
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
| | - I M Skoie
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
| | - I Snekvik
- Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E Jarnaess
- Medical Affairs, AbbVie AS, Fornebu, Norway
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - G Ingvarsson
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
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Longo C, Pampena R, Bombonato C, Gardini S, Piana S, Mirra M, Raucci M, Kyrgidis A, Pellacani G, Ragazzi M. Diagnostic accuracy of ex vivo fluorescence confocal microscopy in Mohs surgery of basal cell carcinomas: a prospective study on 753 margins. Br J Dermatol 2019; 180:1473-1480. [PMID: 30512198 DOI: 10.1111/bjd.17507] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Frozen histological sections are used for intraoperative margin assessment during Mohs surgery. Fluorescence confocal microscopy (FCM) is a new tool that offers a promising and faster alternative to frozen histology. OBJECTIVES To evaluate prospectively in a clinical setting the accuracy of FCM vs. frozen sections in margin assessment of basal cell carcinoma (BCC). METHODS Patients with BCC scheduled for Mohs surgery were prospectively enrolled. Freshly excised surgical specimens were examined by FCM and then frozen sections were evaluated. Permanent sections were obtained, in order to validate the sample technique. A blind re-evaluation was also performed for discordant cases. Sensitivity and specificity levels, as well as positive and negative predictive values (PPV and NPV, respectively), were calculated and receiver-operating characteristic curves generated. RESULTS We enrolled 127 BCCs in as many patients (40·2% females). Seven hundred and fifty-three sections were examined. All BCCs were located in the head and neck area. In evaluating the performance of FCM vs. frozen sections, sensitivity was 79·8%, specificity was 95·8%, PPV was 80·5% and NPV was 95·7% [area under the curve 0·88, 95% confidence interval 0·84-0·92 (P < 0·001)]. Forty-nine discordant cases were re-evaluated; 24 were false positive and 25 false negative. The performance of FCM and frozen sections was also evaluated according to the final histopathological assessment. CONCLUSIONS We found high levels of accuracy for FCM vs. frozen section evaluation in intraoperative BCC margin assessment during Mohs surgery. Some technical issues prevent the wide use of this technique, but new devices promise to overcome these limitations.
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Affiliation(s)
- C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - R Pampena
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - C Bombonato
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - S Gardini
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - S Piana
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Pathology Unit, Reggio Emilia, Italy
| | - M Mirra
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - M Raucci
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - A Kyrgidis
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Ragazzi
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Pathology Unit, Reggio Emilia, Italy
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47
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Moscarella E, Bombonato C, Pampena R, Kyrgidis A, Benati E, Piana S, Borsari S, Lallas A, Pellacani G, Argenziano G, Longo C. Pigmented skin lesions displaying regression features: Dermoscopy and reflectance confocal microscopy criteria for diagnosis. Exp Dermatol 2019; 28:129-135. [DOI: 10.1111/exd.13853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/31/2018] [Accepted: 11/17/2018] [Indexed: 12/01/2022]
Affiliation(s)
| | - Caterina Bombonato
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Athanassios Kyrgidis
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Elisa Benati
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Simonetta Piana
- Pathology Unit; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Stefania Borsari
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Aimilios Lallas
- First Department of Dermatology; Aristotle University; Thessaloniki Greece
| | - Giovanni Pellacani
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | | | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
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48
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Errichetti E, Lallas A, Di Stefani A, Apalla Z, Kyrgidis A, Lacarrubba F, Micali G, Galvan A, Piaserico S, Stinco G. Accuracy of dermoscopy in distinguishing erythroplasia of Queyrat from common forms of chronic balanitis: results from a multicentric observational study. J Eur Acad Dermatol Venereol 2018; 33:966-972. [DOI: 10.1111/jdv.15359] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- E. Errichetti
- Department of Medical Area Institute of Dermatology University of Udine Udine Italy
| | - A. Lallas
- Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Di Stefani
- Division of Dermatology Catholic University of the Sacred Heart Rome Italy
| | - Z. Apalla
- Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Kyrgidis
- Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy
| | - F. Lacarrubba
- Dermatology Clinic University of Catania Catania Italy
| | - G. Micali
- Dermatology Clinic University of Catania Catania Italy
| | | | - S. Piaserico
- Dermatology Unit Department of Medicine Padua University Padua Italy
| | - G. Stinco
- Department of Medical Area Institute of Dermatology University of Udine Udine Italy
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49
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Pourzitaki C, Tsaousi G, Papazisis G, Kyrgidis A, Zacharis C, Kritis A, Malliou F, Kouvelas D. Fentanyl and naloxone effects on glutamate and GABA release rates from anterior hypothalamus in freely moving rats. Eur J Pharmacol 2018; 834:169-175. [DOI: 10.1016/j.ejphar.2018.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022]
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50
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Longo C, Lallas A, Kyrgidis A, Bassoli S, Moscarella E, Pellacani G, Argenziano G. Wide skin markings pattern: melanoma descriptor or patient-related factor?: reply from the authors. Br J Dermatol 2018; 178:1226. [DOI: 10.1111/bjd.16430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Longo
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - A. Lallas
- First Department of Dermatology; Aristotle University; Thessaloniki Greece
| | - A. Kyrgidis
- First Department of Dermatology; Aristotle University; Thessaloniki Greece
| | - S. Bassoli
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - E. Moscarella
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
- Department of Dermatology; University of Campania; Naples Italy
| | - G. Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - G. Argenziano
- Department of Dermatology; University of Campania; Naples Italy
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