Background
Dermoscopy is a widely used technique, recommended in clinical practice guidelines worldwide for the early diagnosis of skin cancers. Intra-European disparities are reported for early ...detection and prognosis of skin cancers, however, no information exists about regional variation in patterns of dermoscopy use across Europe.
Objective
To evaluate the regional differences in patterns of dermoscopy use and training among European dermatologists.
Materials & Methods
An online survey of European-registered dermatologists regarding dermoscopy training, practice and attitudes was established. Answers from Eastern (EE) versus Western European (WE) countries were compared and their correlation with their respective countries’ gross domestic product/capita (GDPc) and total and government health expenditure/capita (THEc and GHEc) was analysed.
Results
We received 4,049 responses from 14 WE countries and 3,431 from 18 EE countries. A higher proportion of WE respondents reported dermoscopy use (98% vs. 77%,
p
<0.001) and training during residency (43% vs. 32%) or anytime (96.5% vs. 87.6%) (
p
<0.001) compared to EE respondents. The main obstacles in dermoscopy use were poor access to dermoscopy equipment in EE and a lack of confidence in one’s skills in WE. GDPc, THEc and GHEc correlated with rate of dermoscopy use and dermoscopy training during residency (Spearman rho: 0.5–0.7,
p
<0.05), and inversely with availability of dermoscopy equipment.
Conclusion
The rates and patterns of dermoscopy use vary significantly between Western and Eastern Europe, on a background of economic inequality. Regionally adapted interventions to increase access to dermoscopy equipment and training might enhance the use of this technique towards improving the early detection of skin cancers.
Methotrexate (MTX) is a systemic immunosuppressant drug used for the treatment of psoriasis and psoriatic arthritis. Previous studies demonstrated a potential association between psoriasis and ...diabetes mellitus, obesity, atherosclerosis, hypertension, eventuating into metabolic syndrome. This study aimed at exploring the glycemic effects of MTX in psoriatic arthritis (PsA) patients. In this prospective cross-sectional study, 27 patients with PsA were evaluated. The status of PsA and presence of accompanying metabolic syndrome was determined by standard criteria and indices. Blood indicators including HbA1c, erythrocyte sedimentation rate, fasting blood sugar, total cholesterol, high-density lipoprotein, triglycerides, and C-reactive protein were examined before and 12 weeks after MTX therapy. There were no significant changes between HbA1c levels before and after MTX therapy in both genders (men: P=0.131, women: P=0.803). In addition, HbA1c levels in PsA patients with metabolic syndrome were not different before and after treatment (P=0.250). Finally, HbA1c levels did not change in PsA patients without metabolic syndrome before and after therapy (P=0.506). MTX in PsA patients does not appear to have hyperglycaemic effects in the short-term and can be safely used in patients with metabolic syndrome and diabetes.
Abstract The malignant melanoma spreading process cannot explain occurrence of metastases several years following local surgical therapy of primary malignancy. But, this complex process of delayed ...metastases is still challenging and not completely understood. We hypotheses that melanoma metastases occur early in disease, probably at the same time with the occurrence of the primary melanoma. We suggest that dissemination of metastatic “seed cells” occur at an early stage of the disease together with the development of primary melanoma and cannot be detected by standard diagnostic methods. These cells are masked between healthy cells and have the potential to proceed in true metastasis following the activation triggered by signal from primary tumor or other source. Other possibility includes the existence of two different genes, one responsible for development of primary melanoma, and the other with a roll in development of metastases. We believe that future investigation should be directed toward better understanding of mechanisms involved in metastases development keeping in mind that melanoma behavior is irrational and defies logical thinking.
The aim of this study was to evaluate the presence of spores and/or hyphae in benign cutaneous tumors (CT) and compare their presence in malignant cutaneous tumors. In this cross-sectional study we ...evaluated 328 CTs positive for spores and/or hyphae. The results show that the greatest number of involved CTs which contained spores and/or hyphae were found in compound nevi 181 (55.18%) and seborrheic warts 61 (18.60%). No spores and/or hyphae were observed in the melanoma samples, and a very low prevalence was found in squamous cell carcinomas (SCCs) (2; 0.61%) and basal cell carcinoma (BCC) (1; 0.30%). The presence of spores and/or hyphae could be a good indicator for non-malignancy, allowing differential diagnosis between benign CTs and SCCs or BCCs as well as between melanoma and nevi.
Abstract Adhesion molecules are proteins on the cell surface that are involved in the interactions between lymphocytes and antigen-presenting cells, especially in inflammatory skin diseases and ...autoimmune bullous disorders. Adhesion molecules include cadherins (subgroups E, N, P, M), integrins, selectins, and the immunoglobulin gene family. Cadherins E in the epidermis including desmocollin 1 and 2 and desmoglein 1 and 3 are essential transmembrane components of desmosome glycoproteins, which play a major role in bullous diseases, pemphigus in particular. Also important are integrin beta 1 alpha 1 and other integrins, which connect ligands of the collagen, laminin, and fibronectin. Selectins (E, P) are important for leukocyte migration on endothelial cells. Adhesion molecules from the immunoglobulin superfamily (intercellular adhesion molecule-1, 3 ICAM-1,3; vascular adhesion molecule-1 VCAM-1) have significant roles in the immune and inflammatory mechanisms.
Psoriasis is a chronic relapsing autoimmune disease with a multigenetic predisposition, which occurs in about 2% of patients in Croatia and shows variable occurrence in the world. Psoriasis can be ...associated with various diseases, including autoimmune diseases (pemphigus, pemphigoid, vitiligo), and slightly less with allergic diseases (atopic dermatitis, asthma, urticaria, allergic contact dermatitis). According to clinical manifestations, psoriasis appears as plaque psoriasis, erythrodermic form and pustular psoriasis. Provocative factors that encourage psoriasis are infections, endogenous factors, hypocalcemia, psychogenic factors and medications. Psoriasis may worsen other dermatoses such as contact dermatitis, inflammatory dermatoses and skin cancer, and the association of psoriasis with internal diseases is quite common (HIV, Crohn's disease, liver lesions, vascular diseases, amyloidosis and gout). Today, psoriasis is considered as a systemic inflammatory disease that can also affect the joints. Atypical localization of psoriasis, as well as resistant cases of psoriasis and other papulosquamous and eczematoid dermatoses require detailed work-up and confirming of diagnosis because of the possibility of the existence of other diseases. This paper discusses the association of psoriasis with rheumatic and other internal diseases.
Recent data suggest that childhood and adulthood stressors may play a significant role in the development of an autoimmune disease. The present study explores the relationship between psoriatic ...arthritis (PsA) and positive and negative life events during childhood and adulthood in psoriatic patients. Forty-five patients with psoriatic arthritis and 101 controls (patients with skin conditions considered to be “non-psychosomatic”) were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences Traumatic Antecedents Questionnaire (TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The patients with psoriatic arthritis exhibited lower mean scores of total positive experiences during late childhood (latency) as compared to the control group. Negative experiences during four developmental periods appeared more frequently in patients with psoriatic arthritis than in the controls. The most frequently reported negative experiences were neglect, emotional abuse, physical abuse, sexual abuse, alcohol/drug abuse and other traumas. The present findings add evidence to the relationship between retrospectively reported childhood experiences and psoriatic arthritis. Furthermore, a high amount of reported emotional and physical abuse occurs in patients with psoriatic arthritis during latency and adolescence.
The corresponding author of the manuscript was inadvertently omitted the author name Marija Kaštelan from the author group of the published article. The revised author group is given below.
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