PubMed Health⌕ Search

Biomedical subjects

N Perez-Oliva

Publications and source records attributed to N Perez-Oliva.

5 recordsLinked to original sources

Surface microscopy for discriminating between common urticaria and urticarial vasculitis.

BACKGROUND: Urticarial vasculitis is a clinicopathological entity that overlaps with common urticaria, and biopsy is required for differentiation between them. OBJECTIVE: To determine, for the first time, if skin surface microscopy can aid in the clinical differentiation between common urticaria and urticarial vasculitis in daily practice. PATIENTS AND METHODS: Lesions in 20 consecutive patients with a clinical diagnosis of urticaria were studied by biopsy and skin surface microscopy (10x dermoscope) after covering the lesions with olive oil. Lesions were photographed with Dermaphot equipment. A biopsy was taken from all patients. Statistical analysis included Fisher's exact test and Cohen kappa statistics (intra-observer reproducibility). RESULTS: Two dermoscopic patterns were observed: (i). a red-lined vascular pattern (17/20 patients); and (ii). a purpuric globular pattern (3/20 patients). Leucocytoclastic vasculitis was demonstrated histologically in all lesions presenting purpuric globules (3/3) but in none of the lesions presenting a dermoscopic red-lined pattern (P < 0.0008). The intra-observer reproducibility for scoring the red lines and purpuric globules was excellent (kappa=0.8). CONCLUSION: The results of this pilot study suggest that skin surface microscopy, using a 10x dermoscope, detects purpuric globules in urticarial lesions, and that purpuric globules indicate underlying leucocytoclastic vasculitis.

Adult↗

Sequential image analysis and measurement of pigmented lesions: false variations due to patient positioning.

Clinical researchers are evaluating the utility of obtaining sequential images of pigmented lesions taken over time for purposes of comparison with the aim of detecting subtle changes suggestive of melanoma. Therefore, the image acquisition process is critical and will need to be strictly standardized before any firm conclusions can be drawn from analysis of sequential images. The influence of patient positioning on the accuracy of sequential image analysis has not been considered in most studies evaluating sequential images. In this experimental study, the influence of patient positioning on the size and shape of an inked circle placed on the skin was determined and measured. Inked circular marks (15 mm in diameter, area 176.71 mm2) were placed on the skin of the lumbar and suprascapular areas of 60 consecutive patients. The diameter and area of the 'circle' was measured with the patient in the prone position with head centred, prone position with head turned to the right, prone position with head turned left, and in the seated position. Statistical analysis was performed with Student's t-tests (paired data). We observed statistically significant differences in the shape, mean maximal diameter and area of the inked circular marks on both the suprascapular area and in the lumbar area after changes of patient positioning (P<0.001). To conclude, the position of the patient must be fixed and standardized during acquisition of sequential images, at least for lesions 15 mm in diameter or larger. Furthermore, it is our opinion that the methods used to control for patient positioning should be reported in the methodology section of studies that report on comparison of sequential images. Only then can we accurately compare sequential images and avoid 'false positive lesion enlargement' being categorized as a true change.

Adolescent↗

[Apocrine nevus].

We present the case of a 32-year-old woman with a congenital lesion on her left cheek that histopathologically was composed of numerous mature apocrine glands. The diagnosis of pure apocrine nevus, a rare lesion of that our case probably represents the sixth described in the literature, was made.

Adult↗