The impact of basal cell carcinoma on the quality-of-life in older patients.

Basal cell carcinoma (BCC) is the most frequent malignant tumour worldwide and incidences are rising rapidly. BCC grow locally, but can invade surrounding tissues. Little is known concerning their impact on the health-related quality of life (HrQoL), and limited available data reports contradicting results.

Migration of Intra-Uterine Devices.

Intrauterine devices (IUDs) are a widely used contraceptive. Possible complications from IUDs include failed insertion, pain, vasovagal reaction, infection, abnormal bleeding, and expulsion. Uterine perforation and migration of the IUD are rare complications occurring in approximately 1-2 per 1000 insertions.

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non-inferiority trial.

Background: Although primary care physicians (PCPs) play a key role in skin cancer screening, their skills in detecting malignant tumours is suboptimal.

Objectives: To determine whether a short dermoscopy e-learning course (4 h) in skin tumour diagnosis for PCPs is non-inferior to a long course (12 h) in selective triage of skin lesions. Secondly, to evaluate whether regular refresher training sessions are necessary to maintain the PCPs' skills in the medium term.

Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists.

Background: The use of dermoscopy improves the diagnosis of skin cancer significantly in trained dermatologists. However, to evaluate its cost-effectiveness in daily practice, not only sensitivity but also the excision rate is important.

Objective: We examined the diagnostic accuracy of cases from a true population-based sample scored by general dermatologists.

Facial Lichen Planopilaris: A Separate Entity or Not? A Case Series.

Lichen planopilaris (LPP) is an inflammatory hair disorder that is characterized by scarring hair loss, mostly affecting the vertex and parietal areas of the scalp. Frontal fibrosing alopecia (FFA) is considered a particular form of LPP, primarily affecting the hair follicles in the frontotemporal area of the scalp, with the hairline recession and eyebrow loss. There are case reports of FFA with concomitant involvement of facial vellus, characterized by roughening of the facial skin.

Pathologic Evaluation of Skin Tumors With Ex Vivo Dermoscopy With Derm Dotting.

Importance: Ex vivo dermoscopy (EVD) with derm dotting (DD) improves clinicopathologic correlation and the quality of diagnosis in skin tumors.

Objective: To compare the diagnostic performance of the standard method of skin biopsy processing with the practice of EVD with DD.

Design, Setting, And Participants: This retrospective study compares the diagnostic performance in 6526 skin biopsy specimens examined from 2008 to 2010 with a standard method of processing with 8584 biopsy specimens examined in 2015 with EVD and DD.

Cost-effectiveness and Budget Effect Analysis of a Population-Based Skin Cancer Screening.

Importance: Several epidemiological studies show an alarming global increase in incidence of melanoma and nonmelanoma skin cancer.

Objectives: To examine the cost-effectiveness of 2 population-based skin cancer screening methods and to assess their budget effect and the influence on skin cancer epidemiological findings.

Design, Setting, And Participants: A Markov model with a latent period of 20 years and a time horizon of 50 years was used to analyze the cost-effectiveness (societal perspective) and budget effect (public health care payer perspective) of 2 population-based skin cancer screening programs in Belgium compared with the absence of a screening program.

Burden of skin cancer in Belgium and cost-effectiveness of primary prevention by reducing ultraviolet exposure.

Skin cancer (melanoma- and non-melanoma skin cancer) is one of the most rapidly increasing cancers worldwide. This study analysed the current and future economic burden of skin cancer in Belgium and the cost-effectiveness of primary prevention of skin cancer. A retrospective bottom-up cost-of-illness study was performed, together with a Markov model in order to analyse the cost-effectiveness and the budget impact analysis of primary prevention of skin cancer in Belgium.

Is early detection of basal cell carcinoma worthwhile? Systematic review based on the WHO criteria for screening.

The incidence of basal cell carcinoma (BCC) has risen three- to fourfold over the last 30 years and is expected to continue to increase with ageing of the population. Although BCC has a good prognosis, it causes significant morbidity and has an important impact on the public health budget due to direct treatment costs. Based on the existing evidence, a systematic evaluation of the World Health Organization criteria was performed to determine whether earlier detection of BCC could reduce morbidity and cost.

Comparison of Ex Vivo and In Vivo Dermoscopy in Dermatopathologic Evaluation of Skin Tumors.

Importance: Ex vivo dermoscopy (EVD) can be a valuable tool in routine diagnostic dermatopathologic evaluation.

Objectives: To compare in vivo dermoscopy (IVD) and EVD and to provide guidance for routine dermatopathologic evaluations.

Design, Setting, And Participants: This observational study collected 101 consecutive IVD and EVD images of skin tumors from a private dermatology practice from March 1 to September 30, 2013.

Total-Body Examination vs Lesion-Directed Skin Cancer Screening.

Importance: Skin cancer is the most frequent cancer type. It remains unknown if and how screening programs can be organized in a cost-effective manner.

Objective: To compare the 2 screening strategies of systematic total-body examination (TBE) and lesion-directed screening (LDS), with a focus on the participation rate, detection rate, anxiety, and cost.

Rosettes and other white shiny structures in polarized dermoscopy: histological correlate and optical explanation.

Background: Rosettes are a specific form of a white shiny structure seen with polarized dermoscopy. The precise morphological correlate and optical explication are not known.

Objective: To estimate the frequency of rosettes in ex vivo dermoscopy and to find explication and morphologic correlate of this dermoscopic feature.

A short dermoscopy training increases diagnostic performance in both inexperienced and experienced dermatologists.

Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin, but only for experienced users. Our aim was to evaluate the effect of short (3-hour) dermoscopy training sessions in both residents and practicing dermatologists. The training improved diagnostic accuracy for both melanocytic and nonmelanocytic neoplasms of the skin and the observed effect was the highest for residents but was also significant for more experienced practicing dermatologists.

The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening.

Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy.

Differentiation of atypical moles (dysplastic nevi) from early melanomas by dermoscopy.

Several conventional and new dermoscopic criteria are highly specific for diagnosing early melanomas. Until the reliability of the dermoscopic scoring systems has been validated, the presence of any combination of these specific features should elevate the index of suspicion for melanoma and prompt a biopsy to avoid missing this cancer.

Current guidelines in melanoma treatment. Melanoma Working Group of Gent and Bordet.

This article focuses on the actual management of cutaneous melanoma, dealing both with established, internationally well-accepted standard procedures and interventions which are still being investigated. It wants to offer a global picture to the dermatologist of what is currently available in the therapeutic arsenal against melanoma.

Risk of cutaneous malignant melanoma in patients with 'classic' atypical-mole syndrome. A case-control study.

Background And Design: There is an increased risk of developing cutaneous malignant melanomas (MMs) in patients with classic atypical-mole syndrome (AMS). This study compares the incidence of newly diagnosed MMs in patients with classic AMS (cases) with the incidence of newly diagnosed MMs developing in a population without classic AMS (control patients). The charts of 287 white patients with AMS and 831 white patients without AMS were reviewed for the occurrence of newly diagnosed invasive MMs during follow-up.

Histopathologic correlates of structures seen on dermoscopy (epiluminescence microscopy).

Dermoscopy (epiluminescence microscopy) is an in vivo technique that enables the clinician to visualize a variety of structures in pigmented cutaneous lesions that are not discernible by naked-eye examination. To identify the histologic correlates of these structures, a series of 71 pigmented neoplasms was documented photographically with and without dermoscopy. These lesions then underwent total excision and careful step-sectioning so that the resulting histologic slides could be correlated with the dermoscopic photographs.

Risk of another basal cell carcinoma developing after treatment of a basal cell carcinoma.

Background: There is an increased risk of new basal cell carcinomas (BCCs) developing in a person who has had a BCC.

Objective: This study attempts to define the magnitude of this increased risk.

Methods: The charts of 260 white patients with a histologically proven BCC were reviewed for the occurrence of new BCCs.

Verification of a formula for determination of preexcision surgical margins from fixed-tissue melanoma specimens.

Background: Recently our group reported on the shrinkage of 199 malignant melanoma surgical-excision specimens. In that report, a multivariate analysis revealed that the age of the patient was the only factor that significantly affected the percentage shrinkage of a surgical specimen. In addition, a formula was presented that extrapolates the actual surgical margins (in vivo) from the (contracted) fixed-tissue pathology report measurement and the reported in vivo lesion diameter.

Influence of gender on survival in patients with stage I malignant melanoma.

Background: Women with stage I malignant melanoma (MM) have a survival advantage over men as judged by univariate analysis. However, on multivariate analysis, gender was found to be an independent predictor of survival in only 8 of 14 published studies.

Objective: This study attempts to explain the disparate findings for gender as a prognostic factor in different multivariate analyses.

Level of education and the risk of malignant melanoma.

Background: The risk for the development of malignant melanoma has been reported to be higher in persons with more formal education than in individuals with less.

Objective: To study whether those with more formal education are indeed at more risk for malignant melanoma than those with less formal education.

Methods: This case-control study explores the relation between education and melanoma risk by analyzing data collected by the American Cancer Society.