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Results for “Skin Pigmentation”

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At least 109 records · Page 6Linked to original sources
PubMed2000

Treatment of vascular lesions in pigmented skin with the pulsed dye laser.

BACKGROUND: Vascular lesions occurring in African-American patients are often not treated because of the risk of local side effects. OBJECTIVE: The study was to determine the efficacy of the flashlamp-pumped dye (FLPD) laser in the treatment of vascular malformations in African-American patients. METHODS: All lesions in three patients were treated with the FLPD laser using a 585 nm wavelength, 5 mm spot size, 450 pulse width, and fluences ranging from 6.5 to 8.5j per cm2. CONCLUSION: The FLPD was effective in treating vascular malformations. Transient changes in colour and skin texture occurred at the treated sites.

Child↗
PubMed2000

Pulsed dye laser treatment of port-wine stains in pigmented skin.

BACKGROUND: Little information is available on pulsed dye laser treatment of darker Fitzpatrick skin types. METHODS: We retrospectively reviewed our clinical experience treating mainly facial (12/13) port-wine stains (PWSs) in 13 patients of skin type V, whose ages ranged from 3 to 65 years. RESULTS: The response was excellent in 2 patients, good or moderate in 4 each, slight in 1, and poor in 2. Hyperpigmentation occurred in 6 patients and hypopigmentation in 1, which improved despite continuing treatment. Limited atrophic scarring developed in two patients. Although these results were less good and side effects more frequent than described in skin types I to IV, 6 patients (46%) achieved a good or excellent response and 85 (87.6%) of the total 97 laser treatments were not associated with significant problems. CONCLUSION: Patients of skin type V with a PWS should not be excluded from pulsed dye laser therapy, provided that treatment expectations and risks are fully discussed.

Adolescent↗
PubMed1995

Epiluminescence microscopy. A useful tool for the diagnosis of pigmented skin lesions for formally trained dermatologists.

BACKGROUND AND DESIGN: Epiluminescence microscopy (ELM) is a noninvasive technique that, by employing the optical phenomenon of oil immersion, makes subsurface structures of the skin accessible for in vivo examination and thus provides additional criteria for the clinical diagnosis of pigmented skin lesions. At present, almost all studies about the value and clinical importance of ELM are based on data derived from ELM experts (ie, dermatologists specifically trained in this technique). In the present study, we attempt to determine whether the clinical diagnosis of pigmented skin lesions is significantly improved using ELM and whether ELM-trained individuals and dermatologists not trained in this technique profit equally from this technique. Randomly selected histologically proven pigmented skin lesion specimens, photographed with (ELM) and without oil immersion (surface microscopy) were presented by slide projection to six ELM experts and 13 ELM nonexperts (ie, dermatologists not formally trained in ELM) for diagnosis. To evaluate the diagnostic performance of ELM experts and nonexperts with and without the oil immersion technique (ie, ELM vs surface microscopy), the following parameters were obtained: intraobserver and interobserver agreement by kappa statistics and sensitivity and specificity of diagnostic performance. RESULTS: Our results show that by using the ELM technique the ELM experts reach a substantially better intraobserver agreement than nonexperts (median kappa, 0.56 vs 0.36). The interobserver agreement was markedly increased in the ELM experts group (average gain, 7%) but decreased in the ELM nonexperts group (average loss, 6%). The sensitivity of diagnosis was significantly increased in the ELM experts group (average gain, 10%), but decreased in the nonexperts group (average loss, 10%). Finally, the specificity of diagnosis was excellent in the ELM experts group, both with and without oil immersion (0.91) and was somewhat improved by ELM in the nonexperts group (0.77 vs 0.85). CONCLUSIONS: We conclude that the ELM technique increases sensitivity in formally trained dermatologists, but may decrease the diagnostic ability in dermatologists not formally trained in the ELM technique. Consequently, formal broad-based training in ELM should be offered to the dermatologic community.

Clinical Competence↗
PubMed1996

Reliability of computer image analysis of pigmented skin lesions of Australian adolescents.

BACKGROUND: The diagnosis of melanomas at an early stage is associated with improved survival, so the recognition of changes in pigmented skin lesions over time is important. We have developed a computer imaging system with the aim of assisting clinicians in differentiating early melanomas from benign pigmented skin lesions. The objective of this study was to investigate the system's reliability over time in measuring diagnostic characteristics of pigmented skin lesions, including their color, size, shape, and distinctness of boundary. METHODS: We captured video images of 5 lesions, all larger than 2 mm in greatest dimension, on each of 66 Australian adolescents on 2 occasions approximately 1 month apart. Features extracted by computer image analysis included area, perimeter, and regularity of outline of the lesions, the mean and standard deviation of reflectance at red, green, and blue wavelengths, and the mean and standard deviation of the gradients of red, green, and blue reflectance at the lesion boundary. RESULTS: All measurements showed moderate to high reliability (intraclass correlation coefficients 0.66-0.94), except for the standard deviations of the color gradients, whose reliability improved to moderate levels (0.68-0.71) when the mean of 5 lesions was considered. For most outcomes, reasonable within subject reliability was achieved when five lesions per subject were measured. CONCLUSIONS: These results, in combination with previous work demonstrating the reasonable ability of this computer imaging system to discriminate between malignant melanomas and other pigmented lesions, indicates that the system has the potential to become a useful tool for clinicians in following people with pigmented lesions over time to detect early malignant changes.

Adolescent↗
PubMed2001

Dermoscopy of pigmented skin lesions--a valuable tool for early diagnosis of melanoma.

The clinical use of dermoscopy has uncovered a new and fascinating morphological dimension of pigmented skin lesions. Dermoscopy is a non-invasive diagnostic technique that links clinical dermatology and dermatopathology by enabling the visualisation of morphological features not seen by the naked eye. Close examination of pigmented skin lesions in this way increases the effectiveness of clinical diagnostic tools by providing new morphological criteria for distinguishing melanoma from other melanocytic and non-melanocytic pigmented skin lesions. In the past, dermoscopy has been known by various names, including skin surface microscopy, epiluminescence microscopy, incident light microscopy, dermatoscopy, and videodermatoscopy. However, the term 'dermoscopy', first used by Friedman and colleagues in 1991, is the most widely used.

Humans↗
PubMed2002

[In vivo differentiation of pigmented skin tumors with laser Doppler perfusion imaging].

BACKGROUND AND OBJECTIVE: Malignant melanomas show a higher heterogeneity in their architecture and a higher vessel density because of neovascularization compared to benign melanocytic skin tumours. In this study the validity of the newly developed Laser Doppler Perfusion Imager (LDPI) with a lateral resolution of 100 microns in the differential diagnosis of pigmented skin tumours was investigated. PATIENTS/METHODS: The perfusion of 116 pigmented skin tumours was s measured with LDPI; 44 malignant melanomas, five melanoma metastases, 59 dysplastic nevi and eight basal cell carcinomas were studied before excision for precise histological diagnosis. RESULTS: There is a significantly higher perfusion of the malignant melanomas (3.15 +/- 1.87 AU) compared to dysplastic nevi (1.14 +/- 0.97 AU) (p < 0.01). By calculating a ratio of the mean perfusion in the tumour and the mean perfusion in adjacent healthy skin, the potential source of error because of regional differences in perfusion is eliminated. The ratio of malignant melanomas (10.78 +/- 9.18) is significantly higher than these of melanoma metastases (4.20 +/- 1.66), basal cell carcinomas (3.24 +/- 1.32) and dysplastic nevi (2.85 +/- 1.32). CONCLUSIONS: The high resolution LDPI has the potential to be a non-invasive screening method for preoperative differential diagnosis of pigmented skin tumours. Besides the epiluminescence microscopy and sonographic determination of the tumour thickness, we have now the possibility to get preoperative information about tumour vascularization.

Adult↗
PubMed1999

Salt water bathing prior to UVB irradiation leads to a decrease of the minimal erythema dose and an increased erythema index without affecting skin pigmentation.

The combination of salt water baths and solar radiation is known as an effective treatment for patients with psoriasis and atopic dermatitis. To determine whether increased susceptibility to UVB radiation may contribute to this therapeutic effect we have studied the effect of bathing the skin in salt water prior to UVB irradiation. Twelve subjects were phototested on the volar aspects of their forearms with increasing doses of UVB radiation. One forearm was exposed to 5% salt water prior to irradiation. The minimal erythema dose (MED) was determined and the erythema index and skin pigmentation were assessed by photometric measurement. The combination of salt water bath and irradiation yielded a significant decrease of the MED when compared to UVB alone (median 90 mJ/cm2 vs 130 mJ/cm2, P < 0.01). Analysis of variance showed a significant influence of salt water bath on erythema (P < 0.05) but not on skin pigmentation. Within the MED test area the erythema index of the salt water exposed forearms was elevated significantly (P < 0.05) while skin pigmentation was not affected. Thus, bathing the skin in salt water leads to a decreased threshold level for the elicitation of UVB-induced erythema and a selective increase of the erythemal response. This sensitization to the effects of shortwave UVB radiation may increase immunosuppressive effects of UVB radiation and may lead to an increased efficacy of UVB phototherapy. However, there is also an increased sunburn risk when salt water baths are followed by exposure to UV radiation.

Adolescent↗
PubMed1999

The diagnostic accuracy of Danish GPs in the diagnosis of pigmented skin lesions.

BACKGROUND: The GP often has a primary function in assessing pigmented skin lesions in Denmark. No data are available on the diagnostic accuracy of this process. OBJECTIVE: We aimed to study the sensitivity, specificity and positive prognostic value of the diagnosis made by 27 trained or trainee GPs. METHOD: We tested the diagnostic accuracy of the viewing of colour slides of pigmented skin lesions under standardized conditions at a seminar on skin cancer. Diagnostic accuracy was determined only for the clinically relevant diagnosis of benign or malignant. RESULTS: The median diagnostic accuracy (sensitivity) for the group as a whole was 0.75 (95% CI 0.65-0.80), the specificity was 0.70 (95% CI 0.68-0.79) and the positive predictive value 0.70 (95% CI 0.62-0.77). CONCLUSION: These values are comparable with previously published figures for trainee dermatologists, and it is therefore concluded that ongoing interest rather than basic training is the major determinant for clinical acumen.

Adult↗
PubMed1987

Influence of caponization on skin pigmentation of male broilers.

Two experiments were conducted to investigate the influence of caponization on skin pigmentation. Male broiler chicks were divided into caponized, sham-operated, and intact treatment groups with surgery performed at 3 weeks of age (Experiment 1) or 1 week of age (Experiment 2). All chicks were provided with corn-soy broiler diets ad libitum. In Experiment 2, an additional 37.4 mg of total xanthophyll was added per kilogram of finisher diet. At 7 weeks of age, birds were processed, comb size was scored, and the gonadal area was examined to identify partially caponized or improperly sexed birds. Caponized, sham-operated, and intact carcasses for analysis totaled, respectively, 28, 25, and 18 in Experiment 1 and 59, 33, and 30 in Experiment 2. Skin pigmentation was measured by reflectance colorimetry on the anterior portion of the lateral feather tract, on the same area of breast skin after removal from the carcass, and on shank skin removed from the leg. No differences were found in skin lightness (L), redness (a), or yellowness (b) between the treatment groups. These results indicate that pigmentation differences between male and female broilers are not likely to be due to differences in testicular activity.

Animals↗