Publications by authors named "Jean-Luc Perrot"

73 Publications

Line field confocal optical coherence tomography: An adjunctive tool in the diagnosis of autoimmune bullous diseases.

J Biophotonics 2021 Feb 14:e202000449. Epub 2021 Feb 14.

Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy.

Autoimmune bullous diseases (AIBDs) still represent a considerable a source of morbidity and mortality: early identification of a specific AIBD is often difficult due to overlapping clinical and/or laboratory features and time-consuming invasive laboratory tests. We aimed to investigate the potential role of a new imaging technology, line-field confocal optical coherence tomography (LC-OCT), in the non-invasive diagnosis of AIBDs. LC-OCT was performed at lesional, perilesional and contralateral healthy sites in 30 patients, before histology and direct immunofluorescence. LC-OCT examination was able to identify the level of split (subcorneal/suprabasal/subepidermal/sublamina densa), to provide detailed images of the bulla roof morphology and content (eg, erythrocytes/acantholytic cells/polymorphonucleates). Areas of intra/subepidermal detachment were also detected also at clinically normal perilesional skin sites. LC-OCT can support physicians, real time and at bed-site, in the differential diagnosis of various AIBDs and their mimickers. Moreover, it can be used for the identification of subclinical lesions and therapy tapering.
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http://dx.doi.org/10.1002/jbio.202000449DOI Listing
February 2021

Human peripheral basophils extended phenotype shows a high expression of CD244 immuno-regulatory receptor.

J Immunol Methods 2021 Jan 22:112951. Epub 2021 Jan 22.

Immunology laboratory, University Hospital Saint-Etienne, 42055 Saint-Etienne, Cedex 2, France; Allergology unit, University Hospital Saint-Etienne, 42055 Saint-Etienne, Cedex 2, France. Electronic address:

Introduction: Basophils play a major physio-pathological role in hypersensitivity related diseases. Basophils express high affinity Immunoglobulin (Ig) E receptors (FcεRI), IgG and complement regulatory. Basophils also have immunoregulatory activity through interaction with T cells. The aim of this study was to look for the expression of markers reflecting the activation status of peripheral Basophil in healthy donors.

Method: the study was performed on 29 healthy donors, 62% females with a mean age of 50.1 + 17.0 years. Basophils were identified on their expression of CD123 without HLA-DR and/or CD193 in two 8 colors panels including CD46, CD55, CD59, CD203c, CD32 (FcγRII), CD64 (FcγRIII), CD163, CD137L (4-1BBL), CD252 (OX40L), CD244 (2B4) and CD3 on whole blood. Basophil activation with anti IgE was performed on 14 donors.

Results And Discussion: Our results confirmed the Basophil expression of CD123, CD193 and CD203 (the latter is strongly increased under stimulation). Complement regulatory proteins (CD46, CD55, CD59) were expressed at the same levels as on other leukocytes; CD46, CD59 expression being slightly increased under stimulation. CD32 and CD163 scavenger were slightly higher than on lympho and not influenced by activation. CD252 or CD137L were expressed at low levels and significantly induced by stimulation. Most of all, CD244 was highly expressed on Basophils as compared to any other leukocytes in fresh peripheral blood.

Conclusions: Our study shows that human resting Basophils express IgE and IgG Fc receptors and check point receptor CD244 that could potentially play a role in their previously reported immunoregulatory activity in sensitization and even in tumor immune escape.
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http://dx.doi.org/10.1016/j.jim.2020.112951DOI Listing
January 2021

Review of Dermoscopy and Reflectance Confocal Microscopy Features of the Mucosal Melanoma.

Diagnostics (Basel) 2021 Jan 8;11(1). Epub 2021 Jan 8.

Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100 Siena, Italy.

Mucosal melanoma is a rare tumor with aggressive biological behavior and poor prognosis. Diagnosis is often performed at an advanced stage when the lesions become symptomatic. Although dermoscopy and reflectance confocal microscopy (RCM) are widely used techniques for the diagnosis of cutaneous tumors, their use for mucosal lesions is not well established, probably because the latter are rarer. The objective of this study was to evaluate current literature on these imaging techniques for mucosal melanoma. We searched in PubMed and Cochrane databases all studies up to October 2020 dealing with dermoscopy, RCM, and mucosal melanoma. We found that the most relevant dermoscopic features were structureless pattern and/or the presence of multiple colors. RCM examination mainly showed numerous basal hyper-reflective dendritic cells and loss of normal architecture of the papillae of the lamina propria. Although diagnostic algorithms have been proposed for both techniques, the limit of these methods is the absence of large studies and of standardized and shared diagnostic criteria.
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http://dx.doi.org/10.3390/diagnostics11010091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827612PMC
January 2021

A new deep learning approach integrated with clinical data for the dermoscopic differentiation of early melanomas from atypical nevi.

J Dermatol Sci 2020 Dec 2. Epub 2020 Dec 2.

Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Italy; Bioengineering Unit, Department of Medical Biotechnology, University of Siena, Italy.

Background: Timely recognition of malignant melanoma (MM) is challenging for dermatologists worldwide and represents the main determinant for mortality. Dermoscopic examination is influenced by dermatologists' experience and fails to achieve adequate accuracy and reproducibility in discriminating atypical nevi (AN) from early melanomas (EM).

Objective: We aimed to develop a Deep Convolutional Neural Network (DCNN) model able to support dermatologists in the classification and management of atypical melanocytic skin lesions (aMSL).

Methods: A training set (630 images), a validation set (135) and a testing set (214) were derived from the idScore dataset of 979 challenging aMSL cases in which the dermoscopic image is integrated with clinical data (age, sex, body site and diameter) and associated with histological data. A DCNN_aMSL architecture was designed and then trained on both dermoscopic images of aMSL and the clinical/anamnestic data, resulting in the integrated "iDCNN_aMSL" model. Responses of 111 dermatologists with different experience levels on both aMSL classification (intuitive diagnosis) and management decisions (no/long follow-up; short follow-up; excision/preventive excision) were compared with the DCNNs models.

Results: In the lesion classification study, the iDCNN_aMSL achieved the best accuracy, reaching an AUC = 90.3 %, SE = 86.5 % and SP = 73.6 %, compared to DCNN_aMSL (SE = 89.2 %, SP = 65.7 %) and intuitive diagnosis of dermatologists (SE = 77.0 %; SP = 61.4 %).

Conclusions: The iDCNN_aMSL proved to be the best support tool for management decisions reducing the ratio of inappropriate excision. The proposed iDCNN_aMSL model can represent a valid support for dermatologists in discriminating AN from EM with high accuracy and for medical decision making by reducing their rates of inappropriate excisions.
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http://dx.doi.org/10.1016/j.jdermsci.2020.11.009DOI Listing
December 2020

Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma.

J Dtsch Dermatol Ges 2021 02 9;19(2):223-229. Epub 2020 Nov 9.

Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.

Background: Lentigo maligna (LM) and lentigo maligna-melanoma (LMM) are histotypes of melanoma arising in skin with cumulative solar radiation damage. The extension of atypical melanocytes to the hair follicle (folliculotropism) is a histopathological feature of LM/LMM. Its role has not been totally clarified, but it may be correlated to treatment response in LM or to progression in LMM.

Objective: This retrospective, multicentric study aims to identify dermatoscopic features associated with folliculotropism in LMs/LMMs.

Patients And Methods: We analyzed cases of head and neck LMs/LMMs diagnosed between 2005-2014 at Melanoma Units, University of Bologna/Modena/Florence/Siena (Italy), Nice (France): 25 LMs and 73 LMMs were included.

Results: Grey circles (44 %) indicated an isthmic/bulb level of involvement, which were completely absent in the infundibular LM lesions (P = 0.041). In the group of LMMs, light/dark brown pseudonetwork and light brown structureless areas were an indicator of diffuse distribution of malignant melanocytes in the follicular units (P < 0.001 and P = 0.001, respectively), while grey circles indicated focal or diffuse distribution (P < 0.001).

Conclusions: A better understanding of the extension of malignant melanocytes is helpful, aiding clinicians in their decision to perform a radical excision or obtaining a biopsy in the most invasive area of the lesion, which includes potential folliculotropism.
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http://dx.doi.org/10.1111/ddg.14311DOI Listing
February 2021

Effectiveness and Safety of Anti-interleukin-17 Therapies in Elderly Patients with Psoriasis.

Acta Derm Venereol 2020 11 4;100(18):adv00316. Epub 2020 Nov 4.

Department of Dermatology, CH Victor Dupouy, FR-95100 Argenteuil, France. E-mail:

Anti-interleukin-17 agents have recently been developed for the treatment of psoriasis. This study evaluated the tolerance and effectiveness of anti-interleukin-17 agents for psoriasis in elderly patients in daily practice. A multicentre, retrospective study was performed, involving psoriatic patients aged ≥65 years who had received an anti-interleukin-17 agent, including secukinumab, ixekizumab or brodalumab. A total of 114 patients were included: 72 received secukinumab, 35 ixekizumab, and 7 brodalumab. Treatment was stopped in 32 patients (28.9%), because of relapses in 14 patients (41.2%), primary failures in 11 patients (32.4%), or adverse events in 7 patients (20.6%). The 3 most frequently reported adverse events were injection site reactions (n = 4), oral candidiasis (n = 3), and influenza-like illness (n = 3). Regarding effectiveness, 80 patients (70%) reached a Physician Global Assessment score of 0/1, 6 months after treatment initiation. In conclusion, anti-interleukin-17 therapy appears to be an effective and safe therapeutic option for psoriasis treatment in patients aged ≥ 65 years.
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http://dx.doi.org/10.2340/00015555-3678DOI Listing
November 2020

Twice-weekly topical calcipotriene/betamethasone dipropionate foam as proactive management of plaque psoriasis increases time in remission and is well tolerated over 52 weeks (PSO-LONG trial).

J Am Acad Dermatol 2020 Sep 18. Epub 2020 Sep 18.

Department of Dermatology and Allergology, Ludwig Maximilian University Munich, Munich, Germany.

Background: Topical psoriasis treatment relies on a reactive rather than a long-term proactive approach to disease relapse.

Objective: Assess long-term efficacy and safety of proactive psoriasis management with twice-weekly calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) foam.

Methods: Phase III trial (NCT02899962) included a 4-week open-label lead-in phase (Cal/BD foam once daily) and a 52-week, randomized, double-blind, maintenance phase. A total of 545 patients achieved treatment success (physician's global assessment "clear"/"almost clear," ≥2-grade improvement from baseline) and were randomized to proactive management (Cal/BD foam; n = 272) or reactive management (vehicle foam; n = 273) twice-weekly, with rescue treatment of Cal/BD foam once daily for 4 weeks upon relapse. Primary endpoint was time to first relapse (physician's global assessment "mild" or higher).

Results: A total of 251 randomized patients (46.1%) completed the trial. Median time to first relapse was 56 days (proactive) and 30 days (reactive). Patients in the proactive group had an additional 41 days in remission compared with the reactive group over 1 year (P < .001). Number of relapses per year of exposure was 3.1 (proactive) and 4.8 (reactive). Cal/BD foam was well tolerated.

Limitations: Maintenance phase dropout rate (53.9%) was within the expected range but provides challenges in statistical analysis.

Conclusion: Long-term proactive management with Cal/BD foam demonstrated superior efficacy vs reactive management.
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http://dx.doi.org/10.1016/j.jaad.2020.09.037DOI Listing
September 2020

Brain metastasis PD-L1 and CD8 expression is dependent on primary tumor type and its PD-L1 and CD8 status.

J Immunother Cancer 2020 08;8(2)

Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France.

Background: Brain metastases (Bmets) are frequent; however, limited data exist on the efficacy of immunotherapy in these lesions. The aims of the study were to analyze the immunohistochemical expressions of programmed death ligand 1 (PD-L1) and CD8 in Bmets and to compare them with their expressions in paired primary tumors, as well as correlate the results with clinicopathological features.

Methods: This is a retrospective study of 233 patients with Bmets and 111 paired primaries. Clinical, histological, and molecular data were recorded and compared with the immunohistochemical results of PD-L1 and CD8 expressions. The statistical analysis included χ test, Cramer's V test, factorial analyses of variance, simple regression analysis, and Kaplan-Meier analysis with log-rank product limit estimation.

Results: PD-L1 expression was found in 23.6% of Bmets and in 29.0% of primary tumors with concordant expression between them in 75.5% of cases. Bmets PD-L1 expression was associated with primary tumor PD-L1 expression and the primary tumor type. Significant CD8 peritumoral expression was found in 68.6% of Bmets and in 87.7% of primary tumors. CD8 expression was concordant between primary and metastatic tumors in 73.3% of cases. Bmets CD8 expression was associated with primary tumor CD8 expression and primary tumor type. PD-L1 expression was associated with CD8 expression in both primary and metastatic tumors. The concordance between primary and metastatic tumor PD-L1 expression was independent of all factors studied. The concordance between primary and metastatic CD8 expressions was marginally associated to the time of Bmets development. No prognostic role for PD-L1 and CD8 expression in Bmets was found.

Conclusion: PD-L1 and CD8 Bmets expressions are associated with the primary tumor type and its PD-L1 and CD8 expressions. No factor predicts the discordance for PD-L1 expression, while time to Bmets development is associated with CD8 expression discordance.
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http://dx.doi.org/10.1136/jitc-2020-000597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454240PMC
August 2020

The Comparative Use of Multiple Electronic Devices in the Teledermoscopic Diagnosis of Early Melanoma.

Telemed J E Health 2020 Aug 14. Epub 2020 Aug 14.

Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy.

The use of mobile electronic devices as support to medical activity was largely implemented in the past decade. Our first aim was to evaluate the frequency of use of different electronic devices, that is, personal computer (PC), notebook, tablet, smartphone, in a pool of dermatologists recruited to perform multiple online testing session on difficult melanocytic skin lesions (MSLs) cases. The second aim was to evaluate the feasibility of each device in terms of teledermatologic diagnostic performance; the use of four different diagnostic methods, that is, intuitive diagnosis and three dermoscopic algorithms, was also investigated. A total of 111 dermatologists with 4 different levels of experience in dermoscopy, performed 4 tests (intuitive diagnosis and iDScore, ABCD rule, 7-point-checklist-based diagnosis) on 979 MSLs blinded cases. Each testing session was performed with a preferred device. The overall highest areas under the receiver operating characteristic (AUROC) (82%) was obtained by young generation dermoscopists 1-4 years experience) when using an integrated clinical dermoscopic algorithm (iDScore) on a notebook. The average dermatologist using the iDScore obtained AUROC 77.40% with large screen devices (PC and notebook) 77.6% with small screen (tablet, smartphone) and 78.2% by combining the two. Young generation of dermoscopists alternately use different devices, whereas elderly generation still prefer to use the PC. The diagnostic performances obtained with small/large screen were not statistically different from those obtained with fixed/mobile devices. Mobile devices were feasible tools to achieve adequate diagnostic accuracy in difficult MSLs, on a teledermatology setting, independently from participant skill level/age.
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http://dx.doi.org/10.1089/tmj.2020.0057DOI Listing
August 2020

New findings in non-invasive imaging of aquagenic keratoderma: Line-field optical coherence tomography, dermoscopy and reflectance confocal microscopy.

Skin Res Technol 2020 Nov 9;26(6):956-959. Epub 2020 Aug 9.

Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.

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http://dx.doi.org/10.1111/srt.12882DOI Listing
November 2020

In vivo and ex vivo confocal microscopy for the evaluation of surgical margins of melanoma.

J Biophotonics 2020 Nov 13;13(11):e202000179. Epub 2020 Aug 13.

Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy.

We report the first series of melanomas (MMs) where the surgical margins were evaluated both by ex vivo confocal microscopy (EVCM) and in vivo reflectance confocal microscopy (RCM). We evaluated the surgical margins of 42 cutaneous MMs of lentigo maligna/lentigo maligna melanoma type and 2 mucosal MMs with EVCM. Cutaneous MMs also underwent RCM mapping. Imaging results were compared with histopathology. The rate of correct identification of the tumor margins (invaded or not invaded) was 97.6% for RCM (evaluations of cutaneous MMs) and 95.5% for EVCM (evaluations of both cutaneous and mucosal MMs). Our study showed that the MM extension is visible under EVCM and that the combination of in vivo RCM and EVCM can be a new strategy for the evaluation of surgical margins of MMs.
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http://dx.doi.org/10.1002/jbio.202000179DOI Listing
November 2020

Kaposi sarcoma of the glans: New findings by line field confocal optical coherence tomography examination.

Skin Res Technol 2020 Jul 23. Epub 2020 Jul 23.

Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.

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http://dx.doi.org/10.1111/srt.12938DOI Listing
July 2020

Delayed Tattoo Reaction From Red Dye With Overlapping Clinicopathological Features: Examination With High-Frequency Ultrasound and Line-Field Optical Coherence Tomography.

Dermatol Pract Concept 2020 Jul 29;10(3):e2020053. Epub 2020 Jun 29.

Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.

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http://dx.doi.org/10.5826/dpc.1003a53DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346588PMC
July 2020

Hematoma-like metastases in melanoma: Ultrasound findings.

Skin Res Technol 2020 09 16;26(5):757-758. Epub 2020 Mar 16.

Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy.

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http://dx.doi.org/10.1111/srt.12845DOI Listing
September 2020

Examination of circumscribed palmar hypokeratosis with line-field confocal optical coherence tomography: Dermoscopic, ultrasonographic and histopathologic correlates.

Indian J Dermatol Venereol Leprol 2020 Mar-Apr;86(2):206-208

Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.

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http://dx.doi.org/10.4103/ijdvl.IJDVL_546_19DOI Listing
December 2020

Beware of reflectance confocal microscopy artifacts when searching hyphae in acral skin.

An Bras Dermatol 2020 Jan - Feb;95(1):129-130. Epub 2019 Dec 31.

Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy.

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http://dx.doi.org/10.1016/j.abd.2019.04.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058874PMC
March 2020

[Will France ever have a radio-vigilance office?]

Bull Cancer 2019 Dec 23;106(12):1067-1069. Epub 2019 Jul 23.

Hôpital S. Maria alle Scotte, université de Sienne, département de science médicale, chirurgicale et neurologique, unité de dermatologie, Sienne, Italie.

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http://dx.doi.org/10.1016/j.bulcan.2019.05.007DOI Listing
December 2019

Ingenol mebutate to treat lentigo maligna of the head (face and scalp): A prospective, multicenter, single-arm phase 2 trial indicates no benefit.

J Am Acad Dermatol 2020 03 17;82(3):731-733. Epub 2019 Jul 17.

Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France; Team 12, Centre Méditerranéen de Médecine Moléculaire, INSERM, U1065, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France.

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http://dx.doi.org/10.1016/j.jaad.2019.07.035DOI Listing
March 2020

Three-dimensional maps of human skin properties on full face with shadows using 3-D hyperspectral imaging.

J Biomed Opt 2019 06;24(6):1-14

University of Lyon, UJM-Saint-Etienne, CNRS, Institut d Optique Graduate School, Laboratoire Hubert, France.

Hyperspectral imaging has shown great potential for optical skin analysis by providing noninvasive, pixel-by-pixel surface measurements from which, applying an optical model, information such as melanin concentration and total blood volume fraction can be mapped. Such applications have been successfully performed on small flat skin areas, but existing methods are not suited to large areas such as an organ or a face, due to the difficulty of ensuring homogeneous illumination on complex three-dimensional (3-D) objects, which leads to errors in the maps. We investigate two methods to account for these irradiance variations on a face. The first one relies on a radiometric correction of the irradiance, using 3-D information on the face's shape acquired by combining the hyperspectral camera with a 3-D scanner; the second relies on an optimization metric used in the map computation, which is invariant to irradiance. We discuss the advantages and drawbacks of the two methods, after having presented in detail the whole acquisition setup, which has been designed to provide high-resolution images with a short acquisition time, as required for live surface measurements of complex 3-D objects such as the face.
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http://dx.doi.org/10.1117/1.JBO.24.6.066002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977068PMC
June 2019

Multispectral three-dimensional imaging for chronic wound modelization: Proof of concept.

Skin Res Technol 2019 Nov 20;25(6):903-905. Epub 2019 May 20.

Dermatology Unit, Saint-Etienne University Hospital, Saint-Etienne, France.

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http://dx.doi.org/10.1111/srt.12720DOI Listing
November 2019

Ex vivo confocal microscopy for dermatofibrosarcoma protuberans.

Skin Res Technol 2019 07 12;25(4):589-591. Epub 2019 Mar 12.

Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.

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http://dx.doi.org/10.1111/srt.12690DOI Listing
July 2019

Safety assessment of anticancer drugs in association with radiotherapy in metastatic malignant melanoma: a real-life report : Radiation/systemic drug combo in metastatic melanoma.

Cancer Chemother Pharmacol 2019 05 26;83(5):881-892. Epub 2019 Feb 26.

Institut de Cancérologie Lucien Neuwirth, 108 bis Avenue Albert Raimond, BP 60008, 42271, St Priest en Jarez cedex, France.

Purpose: To assess the safety of the association of radiotherapy (RT) and systemic treatments for patients with metastatic malignant melanoma (mMM).

Methods: A retrospective analysis included consecutive patients treated with palliative RT, and at least one line of systemic therapy for mMM between 2001 and 2016. Treatments were defined as sequential or concomitant when RT and the systemic drug were administered, respectively, at more or less than five half-lives from each other.

Results: 92 patients were included. They had 110 palliative RT treatments. RT was delivered with a "conventional" chemotherapy (mainly fotemustine and/or dacarbazine) and a "modern" systemic therapy (BRAF inhibitors, association of BRAF and MEK inhibitors, immunotherapy), respectively, in 88 (80%) and 22 (20%) cases. Systemic treatments and RT were mainly concurrently performed (n = 61, 55.5%). Regarding acute grade ≥ 3 toxicity, no difference was reported between sequential and concomitant groups either in the whole cohort (p = 1) or in the subgroup of patients receiving "modern" systemic therapies (p = 1). Acute and late grade ≥ 3 toxicities only occurred with vemurafenib. BRAF inhibitors and RT produced more severe infield adverse events than other associations (p = 0.001) with two deaths.

Conclusion: In our series, compared to sequential administration, concomitant association of systemic anticancer drugs and palliative RT did not increase toxicity in mMM patients. BRAF inhibitors and RT produced severe infield toxicities. Prospective studies are needed to better characterize the toxicity of each association.
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http://dx.doi.org/10.1007/s00280-019-03806-5DOI Listing
May 2019

Dermoscopic and reflectance microscopy features of primary and metastatic Merkel cell carcinoma: Ten cases.

Skin Res Technol 2019 May 28;25(3):407-409. Epub 2018 Dec 28.

Department of Medical, Surgical and Neurological Science - Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy.

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http://dx.doi.org/10.1111/srt.12658DOI Listing
May 2019

Preliminary experience of the use of high-resolution skin ultrasound for the evaluation of extrathyroidal manifestations of Graves' disease and response to UVA-1 phototherapy.

Photodermatol Photoimmunol Photomed 2019 03 24;35(2):129-131. Epub 2019 Jan 24.

Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy.

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http://dx.doi.org/10.1111/phpp.12442DOI Listing
March 2019

How transparent film applied on dermatologic imaging devices in order to prevent infections affects image quality?

Skin Res Technol 2019 Mar 27;25(2):229-233. Epub 2018 Oct 27.

Department of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy.

Background: In the clinical practice, transparent films are used as sterile interfaces in in vivo dermatologic imaging in order to prevent the transmissions of infections. However, in our experience, the use of a transparent film can alter skin images. Our study aimed to compare the optical quality of a series of different plastic films used as interfaces in order to understand if some might be more suitable for imaging.

Materials And Methods: We tested the optical properties of 11 different protective transparent films that are marketed in France with a transparency meter and a spectrophotometer.

Results: Transmission, minimal diffusion, amount of gray, and contrast were obtained for each transparent film. Transmission ranged from 93.24% to 96.88% (mean 95.36; standard deviation SD 1.02), minimal diffusion from 88.28% to 123.87% (mean 101.04; standard deviation SD 10.02) and contrast from 11.01 to 15.88 (mean 13.93 and SD 1.3). For some films, the transmission was lower at lower wavelengths.

Conclusion: All tested films had excellent optical properties. However, some of them had better optical qualities and seemed more suitable for their use in dermatologic imaging.
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http://dx.doi.org/10.1111/srt.12642DOI Listing
March 2019

Line-field confocal optical coherence tomography for high-resolution noninvasive imaging of skin tumors.

J Biomed Opt 2018 10;23(10):1-9

University Hospital of Saint-Etienne, Saint-Etienne, France.

An optical technique called line-field confocal optical coherence tomography (LC-OCT) is introduced for high-resolution, noninvasive imaging of human skin in vivo. LC-OCT combines the principles of time-domain optical coherence tomography and confocal microscopy with line illumination and detection using a broadband laser and a line-scan camera. LC-OCT measures the echo-time delay and amplitude of light backscattered from cutaneous microstructures through low-coherence interferometry associated with confocal spatial filtering. Multiple A-scans are acquired simultaneously while dynamically adjusting the focus. The resulting cross-sectional B-scan image is produced in real time at 10  frame  /  s. With an isotropic spatial resolution of ∼1  μm, the LC-OCT images reveal a comprehensive structural mapping of skin at the cellular level down to a depth of ∼500  μm. LC-OCT has been applied to the imaging of various skin lesions, in vivo, including carcinomas and melanomas. LC-OCT images are found to strongly correlate with conventional histopathological images. The use of LC-OCT as an adjunct tool in medical practice could significantly improve clinical diagnostic accuracy while reducing the number of biopsies of benign lesions.
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http://dx.doi.org/10.1117/1.JBO.23.10.106007DOI Listing
October 2018

Noninvasive diagnosis of liquefied gouty tophus: Reflectance confocal microscopy as an alternative to polarizing light microscopy analysis.

Skin Res Technol 2019 Mar 16;25(2):240-241. Epub 2018 Oct 16.

Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.

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http://dx.doi.org/10.1111/srt.12627DOI Listing
March 2019

Dermoscopy for the Diagnosis of Conjunctival Lesions.

Dermatol Clin 2018 Oct 16;36(4):439-449. Epub 2018 Aug 16.

Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena 53100, Italy.

This article describes the present literature on dermoscopy of conjunctiva and shows the results of a dermoscopy study of 147 conjunctival tumors. Melanomas were characterized by a heavy pigmentation, irregular dots, and a higher prevalence of gray color compared with nevi. Squamous cell carcinomas had peculiar hairpin and glomerular vessels. Primary acquired melanoses were characterized by regularly distributed light brown dots. A large part of nevi had small cysts.
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http://dx.doi.org/10.1016/j.det.2018.05.011DOI Listing
October 2018