Rapid Lump Examination (RLE) - a bedside 3-dimensional microscopy of tumor specimens.

Background: Due to rising skin cancer incidence rates there is an urgent need for a quick, reliable and cost-effective therapy. Previous studies showed that fresh tumor tissue and margins could be directly examined microscopically with high sensitivity and specificity.

Objective: Comparing the accuracy of rapid lump examination (RLE) for the detection of basal cell carcinoma (BCC) during micrographic surgery with formalin-fixed paraffin-embedded hematoxylin and eosin (HE)-stained sections.

Rapid Lump Examination as a New Aid to Speedup Mohs Micrographic Surgery: A Pilot Study.

Background: Although most cases of basal cell carcinoma (BCC) are curable, facial and recurrent BCCs require time consuming and labor-intensive Mohs micrographic surgery (MMS) to ensure complete removal with optimal cosmetic results. To handle the skin cancer epidemic, there is an urgent need to speedup MMS. Recently, rapid lump examination (RLE) has been shown to enable quick histologic examination, but its usefulness within MMS is unknown.

Banana leaves as an alternative wound dressing.

Background: There is a need for cheap and efficacious wound dressings in developing countries. Banana leaves have been described as an excellent, inexpensive, easily available dressing material in tropical countries. As a natural product, banana leaves are heavily contaminated with various pathogens that must be removed before they can be used as wound dressings, but effective sterilization methods that do not affect the beneficial wound-dressing properties of banana leaves have not been described.

Topical timolol for small hemangiomas of infancy.

Propranolol has become the treatment of choice of large and complicated infantile hemangiomas. There is a controversy concerning the safety of systemic propranolol. Here we show that topical use of the beta-blocker timolol can also inhibit the growth and promote regression of infantile hemangiomas.

Extramammary Paget's disease: extended subclinical growth detected using three-dimensional histology in routine paraffin procedure and course of the disease.

Background: Extramammary Paget's disease (EMPD) is a rare tumor of the skin characterized by extended irregular subclinical growth and high recurrence rates after surgery.

Objective: To show that, using three-dimensional (3D) histology in surgical excision, the size of the safety margin can be individually determined and locally adjusted to subclinical growth and to evaluate the course of the disease in 33 patients.

Methods: The clinical records of 33 patients with primary lesions of EMPD were prospectively documented, retrospectively confirmed, and analyzed.

Rapid lump examination (RLE) - a new tool for Mohs surgery?

Background: "Micrographic surgery" spares tissue and results in fewer recurrences. Various techniques have been described using paraffin-embedded and cryostat sections or even optical sections from ex vivo confocal laser scanning microscopy. The presented technique is the rapid direct microscopy of the surface of a specimen (lump) for a pathological examination (RLE).

Wavelet analysis of skin blood flow in dermatosurgery using primary closure with tension.

Primary closure in dermatologic surgery is state of the art in small lesions at the head, but also in larger lesions at the trunk or the extremities. Microcirculatory effects on the skin blood flow near to the wound edges affected by primary closure. Forty three patients were investigated.

Confocal laser scanning microscopy vs 3-dimensional histologic imaging in basal cell carcinoma.

Objective: To compare ex vivo confocal laser scanning microscopy (CLSM), which offers rapid images without the need for tissue processing, vs 3-dimensional histologic imaging, the criterion standard treatment for basal cell carcinomas in high-risk areas of the face.

Design: Single-center prospective trial.

Setting: Dermatosurgical unit of a university hospital.

Sentinel lymph node dissection in primary melanoma reduces subsequent regional lymph node metastasis as well as distant metastasis after nodal involvement.

Background: In many countries sentinel lymph node dissection (SLND) followed by complete lymphadenectomy if positive is routinely performed treatment for primary cutaneous melanoma. However, the potential survival benefit of SLND is still controversial.

Methods: Patients with primary cutaneous melanoma (tumor thickness 1.

Nodular malignant melanoma and multiple cutaneous neoplasms under immunosuppression with azathioprine.

Immunosuppressed patients are at increased risk of skin cancer. A 67-year-old renal transplant recipient developed a nodular malignant melanoma after 30 years of immunosuppression with azathioprine and prednisolone. The patient died of metastatic disease 3 months after the diagnosis was made.

Sun protection by red wine?

Background: There is increasing evidence that polyphenols, antioxidants from plants such as green tea or grapes, may impair the UV-induced erythema reaction as well as carcinogenesis and metastasis of melanoma and epithelial skin cancer. The UVB-protective potential of wine polyphenols has not been studied so far in humans.

Patients And Methods: We tested the influence of local and systemic application of three red wines on the minimal erythema dose (MED) after UVB exposure in 15 healthy male physicians.

Changes in acral blood flux under local application of ropivacaine and lidocaine with and without an adrenaline additive: a double-blind, randomized, placebo-controlled study.

Vascular effects of local anesthetics are especially important in dermatological surgery. In particular, adequate perfusion must be ensured in order to offset surgical manipulations during surgical interventions at the acra. However, the use of adrenaline additives appears fraught with problems when anesthesia affects the terminal vascular system, particularly during interventions at the fingers, toes, penis, outer ears, and tip of the nose.

Age and gender are significant independent predictors of survival in primary cutaneous melanoma.

Background: The aim was to identify age- related and gender-related differences in the clinical presentation and outcome of patients with primary cutaneous melanoma (CM).

Methods: A total of 4785 CM patients without clinical evidence of metastasis diagnosed during the period 1976-2001 in southern Germany included in the analysis. Kaplan-Meier analyses were performed to estimate and to compare disease-specific survival (DSS) and survival after first recurrence (SAR).

Outdoor sports and skin cancer.

Ultraviolet radiation is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. Athletes practicing outdoor sports receive considerable UV doses because of training and competition schedules with high sun exposure, and in alpine sports, by altitude-related increase of UV radiation and reflection from snow- and ice-covered surfaces. Extreme UV exposure in outdoor sports such as skiing, mountaineering, cycling, or triathlon has been documented in a series of dosimetric studies.

Melanoma of the nose: prognostic factors, three-dimensional histology, and surgical strategies.

Objectives: The prominent position of the nose in the face accounts for its constant exposure to sunlight and thus its high incidence of malignant involvement. The aim of this prospective study was to define prognostic factors for nasal melanomas and to evaluate surgical strategies.

Methods: Forty-five patients with stage I/II melanoma were included.

UV exposure in cars.

Background: There is increasing knowledge about the hazards of solar and ultraviolet (UV) radiation to humans. Although people spend a significant time in cars, data on UV exposure during traveling are lacking. The aim of this study was to obtain basic information on personal UV exposure in cars.

"Functional" surgery in subungual melanoma.

Background: Subungual melanomas represent approximately 2% to 3% of cutaneous melanomas in White populations. Complete or partial amputation proximal to the distal interphalangeal joint of the digits has been suggested. Recently, we introduced for acral melanomas, similar to lentigo maligna melanoma, limited excision and complete histology of excisional margins (three-dimensional histology).

Continuous long-term monitoring of UV radiation in professional mountain guides reveals extremely high exposure.

Ultraviolet radiation (UVR) is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. High occupational UV exposure is assumed to be associated with skin cancer. Mountain guides receive considerable UV doses due to altitude-related increase of UVR and reflection from snow- and ice-covered surfaces.